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

Hayashi, Fátima Kiyoko; Ayres, Pedro Paulo Marino Rodrigues; Miethke-Morais, Anna; Sousa, Mayson Laércio de Araújo; Barbas, Carmen Sílvia Valente; Costa, Eduardo Leite Vieira; Caruso, Pedro; Ferreira, Juliana Carvalho

doi:10.36416/1806-3756/e20190108

Cited by 5 publications

(4 citation statements)

References 25 publications

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“…44 Another study explored the impact of competency-based education on resident physicians' learning related to MV and reported an increase from baseline 31% to 96% in residents' ventilator management confidence. 45 Critical care competencies in the current study also appeared to impact discharge outcomes. Patients requiring proning had better discharge outcomes when the RT who provided their respiratory care immediately prior to the proning session had completed critical care competencies.…”

Section: Discussionmentioning

confidence: 63%

RT education and COVID-19 pneumonia discharge quality

Kaur,

Geistkemper,

Mitra

et al. 2023

Canadian Journal of Respiratory Therapy

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Background There is a lack of data assessing the influence of respiratory therapist (RT) education on clinical outcomes. The primary objective of this study was to evaluate the impact of RTs holding advanced degrees or completing adult critical care competencies on discharge outcomes of patients with COVID-19 pneumonia. Study Design and Methods This retrospective, cross-sectional study included adults with confirmed COVID-19 admitted to the hospital for at least three days between March-May 2020. The academic degree held by each RT was considered advanced (baccalaureate or higher) or associate degree. Discharge outcomes were considered good, compromised, or poor when subjects’ hospital discharge was directly to home, long-term care facility/rehabilitation center, or hospice/died, respectively. A time-to-event multi-state regression model was used to determine the impact of RT academic degree and adult critical care competencies on discharge outcomes using α=0.05. Results A total of 260 subjects (median age 59 y; 166 males) received clinical care from 132 RTs. RT median professional experience was six y (IQR 3-11), 70.8% had an advanced degree, and 70.8% completed adult critical care competencies. The time-to-event multi-state regression model showed that patients with >85% exposure to RTs with advanced degrees transitioned 3.72 times more frequently to good outcomes than RTs without advanced degrees (p=.001). Similarly, patients with >85% exposure to RTs with adult critical care competencies transitioned 5.10 times more frequently to good outcomes than RTs without adult critical care competencies (p<.001). Conclusion Patients with COVID-19 pneumonia who received greater than 85% of their care by RTs who earned advanced degrees or completed adult critical care competencies had improved discharge outcomes. This preliminary work suggests that advancing education for the respiratory therapist workforce may improve the discharge quality of patients with acute respiratory failure and should be further explored.

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Section: Discussionmentioning

confidence: 63%

RT education and COVID-19 pneumonia discharge quality

Kaur,

Geistkemper,

Mitra

et al. 2023

Canadian Journal of Respiratory Therapy

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“…Medical training assumes paramount significance. Rotations and training programs have the potential to enhance physicians' proficiency in mechanical ventilation and their capacity to interpret ventilator waveforms [ [22] , [23] , [24] ]. Training and technology will complement each other to significantly improve and enhance physicians' ability to recognize and manage PVA [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Application of a cloud platform that identifies patient-ventilator asynchrony and enables continuous monitoring of mechanical ventilation in intensive care unit

Chen,

Fan,

Zhao

et al. 2024

Heliyon

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“…It has been previously shown that one month of ICU rotation with a competency-based approach, increases the residents” confidence (31%-96% P < .001) in something as complicated as mechanical ventilation settings, provided the objectives are well-defined and regular instruction and supervision is maintained throughout the rotation. 21 In another study, perceived adequacy of ventilator knowledge and awareness of learning objectives during ICU rotation were found to be significantly associated with better performance (77% vs 70%, P = .0005) on the postrotation evaluation test. 5…”

Section: Discussionmentioning

confidence: 99%

The Impact of Short Intensive Care Rotation on Residents’ Experience in the COVID-19 Pandemic: A Mixed-Methods Study

Khan,

Aziz,

Riaz

et al. 2023

Journal of Medical Education and Curricular Development

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Objectives To assess the impact and utility of an intensive care unit (ICU) rotation during the coronavirus disease 2019 (COVID-19) pandemic and the need for mandatory ICU rotations in training for all clinical specialties. Methods A mixed methods study was conducted from January to September 2021 at the Aga Khan University Hospital, including resident doctors who rotated through COVID ICU between May and September 2020. An online survey was undertaken, followed by two focused group discussions (FGDs). Results Fifty-nine complete responses out of a total of 86 were analyzed. Around 42.3% (n = 25) of doctors belonged to medicine/allied specialties and 57.6% (n = 34) had previous ICU experience. Both groups, with and without prior ICU experience, found the rotation equally challenging (82.3% (n = 28) versus 84% (n = 21), P = .776) and gained similar practical skills (35.3% (n = 12) versus 16% (n = 4), P = .072), however, those with experience gained significantly more knowledge (58.5% (n = 20) versus 32% (n = 8), P = .047). On opinion regarding mandatory ICU rotation, the majority agreed to have a mandatory rotation (82% (n = 28) versus 72% (n = 18), P = .421)) with an optimal duration of 1 to 2 months. The FGDs found that all residents encouraged the idea of mandatory training in ICU which must be tailored to their training specialty and suggested extending the duration beyond 1 week to ensure learning. Conclusions COVID ICU rotation was a good avenue for learning and the idea of mandatory ICU training was supported. Mandating ICU rotation might theoretically enhance response to emergencies. More research is needed to understand for feasible incorporation of ICU training in the curriculum.

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

Cited by 5 publications

References 25 publications

RT education and COVID-19 pneumonia discharge quality

RT education and COVID-19 pneumonia discharge quality

Application of a cloud platform that identifies patient-ventilator asynchrony and enables continuous monitoring of mechanical ventilation in intensive care unit

The Impact of Short Intensive Care Rotation on Residents’ Experience in the COVID-19 Pandemic: A Mixed-Methods Study

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