Mechanical Ventilation Boot Camp: A Simulation-Based Pilot Study

Abstract

Objectives. Management of mechanically ventilated patients may pose a challenge to novice residents, many of which may not have received formal dedicated critical care instruction prior to starting their residency training. There is a paucity of data regarding simulation and mechanical ventilation training in the medical education literature. The purpose of this study was to develop a curriculum to educate first-year residents on addressing and troubleshooting ventilator alarms. Methods. Prospective evaluation was conducted of seventeen residents undergoing a twelve-hour three-day curriculum. Residents were assessed using a predetermined critical action checklist for each case, as well as pre- and postcurriculum multiple-choice cognitive knowledge questionnaires and confidence surveys. Results. Significant improvements in cognitive knowledge, critical actions, and self-reported confidence were demonstrated. The mean change in test score from before to after intervention was +26.8%, and a median score increase of 25% was noted. The ARDS and the mucus plugging cases had statistically significant improvements in critical actions, p < 0.001. A mean increase in self-reported confidence was realized (1.55 to 3.64), p = 0.049. Conclusions. A three-day simulation curriculum for residents was effective in increasing competency, knowledge, and confidence with ventilator management.

Parameters for Simulation of Adult Subjects During Mechanical Ventilation

“…One obvious application, and the primary purpose of this study, is to provide the basis of simulationbased medical education and research, particularly in the art and science of mechanical ventilation. 62 Simulationbased medical education and simulation-based mastery learning have become well-established in undergraduate and graduate medical, nursing, and allied health-care training programs. 63 Much like a standardized patient, 64 a highfidelity lung simulator can provide the framework for teaching virtually any aspect of the physical interaction of a patient and a mechanical ventilator.…”

Impact of a respiratory ICU rotation on resident knowledge and confidence in managing mechanical ventilation

“… 20 This is probably due, in part, to the fact that instruction in MV is not well standardized, because there is no widely used list of competencies in MV, nor is there consensus on how to develop a specific curriculum in MV and to quantify learning. 18 , 24 , 27 - 29 …”

“…However, the increase in the mean total score after the rotation shows a significant gain of knowledge after the training focused on MV management, a gain that was also observed in a study involving residents who underwent intensive training in MV. 27 …”

“…That could be attributed to the training and discussions that took place during the rotation, corroborating findings from similar studies. 27 The high rate of correct answers to some questions before the rotation may be related to knowledge of MV gained during previous rotations or to the varying degree of difficulty of the questions.…”

Telepresent mechanical ventilation training versus traditional instruction: a simulation-based pilot study

“…Yee et al reported that a 12-hour simulation-based mechanical ventilation boot camp significantly improved the confidence, knowledge and performance of first-year residents in the management of the ventilated patient 12. Similarly, Spadaro et al have demonstrated improved knowledge and skills of anaesthesia residents who were taught acute respiratory distress syndrome (ARDS) management with manikin-based simulation, in contrast to computer-based simulation.…”