BackgroundMechanical ventilation is a complex topic that requires an in-depth understanding of the cardiopulmonary system, its associated pathophysiology and comprehensive knowledge of equipment capabilities.IntroductionThe 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 methodsMedical 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).ResultsA 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.DiscussionWhile 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.ConclusionsTelementoring 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.
The demand for advanced practice providers (APPs) is increasing across the United
States to meet necessary provider staffing requirements including in intensive
care settings. Currently, participation in formal postgraduate training
programs, or residencies, for APPs is not required for clinical practice, such
that most of the APPs immediately enter into the workforce following completion
of their initial graduate-level training. Consequently, this results in a
supervised training period until APPs develop the necessary competencies to
practice more autonomously. Educational programs that support specialty
competency development may facilitate the transition of APPs into clinical
practice, allowing them to be credentialed to perform essential procedures as
quickly as possible. The goal of this boot camp was to provide training for APPs
in common critical care, high-risk procedures, and to provide leadership
development for high-risk cases to expedite their orientation process. The
following manuscript describes our experience with the development,
implementation, and short-term evaluation of this training program.
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