Telepresent mechanical ventilation training versus traditional instruction: a simulation-based pilot study. (24th February 2018)

• Record Type: Journal Article
• Authors: Ciullo, Anna; Yee, Jennifer; Frey, Jennifer A; Gothard, M David; Benner, Alma; Hammond, Jared; Ballas, Derek; Ahmed, Rami A
• Other Names: Fuenning Charles R author non-byline.; George Richard L author non-byline.
• Is Part Of: BMJ simulation & technology enhanced learning. Volume 5:Number 1(2019)
• Page Start: 8
• Page End: 14
• Publication Date: 2018-02-24
• Subjects: simulation -- telementoring -- mechanical ventilation -- critical care -- DASH -- telepresence; Medicine -- Simulation methods -- Periodicals; Medical innovations -- Periodicals; 610.113
• DOI: 10.1136/bmjstel-2017-000254
• Languages: English
• ISSNs: 2056-6697

Abstract

Abstract : Background: Mechanical ventilation is a complex topic that requires an in-depth understanding of the cardiopulmonary system, its associated pathophysiology and comprehensive knowledge of equipment capabilities. Introduction: The use of telepresent faculty to train providers in the use of mechanical ventilation using medical simulation as a teaching methodology is not well established. The aim of this study was to compare the efficacy of telepresent faculty versus traditional in-person instruction to teach mechanical ventilation to medical students. Materials and methods: Medical students for this small cohort pilot study were instructed using either in-person instruction or telementoring. Initiation and management of mechanical ventilation were reviewed. Effectiveness was evaluated by pre- and post-multiple choice tests, confidence surveys and summative simulation scenarios. Students evaluated faculty debriefing using the Debriefing Assessment for Simulation in Healthcare Student Version (DASH-SV). Results: A 3-day pilot curriculum demonstrated significant improvement in the confidence (in person P<0.001; telementoring P=0.001), knowledge (in person P<0.001; telementoring P=0.022) and performance (in person P<0.001; telementoring P<0.002) of medical students in their ability to manage a critically ill patient on mechanical ventilation. Participants favoured the in-person curriculum over telepresent education, however, resultant mean DASH-SV scores rated both approaches as consistently to extremely effective. Discussion: While in-person learners demonstrated larger confidence and knowledge gains than telementored learners, improvement was seen in both cases. Learners rated both methods to be effective. Technological issues may have contributed to students providing a more favourable rating of the in-person curriculum. Conclusions: Telementoring is a viable option to provide medical education to medical students on the fundamentals of ventilator management at institutions that may not have content experts readily available.