Effectiveness of Medical Resident Education in Mechanical Ventilation

Cox, Christopher E.; Carson, Shannon S.; Ely, E. Wesley; Govert, Joseph A.; Garrett, Joanne M.; Brower, Roy G.; Morris, David G.; Abraham, Edward; Donnabella, Vincent; Spevetz, Antoinette; Hall, Jesse B.

doi:10.1164/rccm.200206-624oc

Cited by 70 publications

(72 citation statements)

References 28 publications

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“…1 As a result, many postgraduate year (PGY)-1 internal medicine residents lack competency in critical care skills. 2 Educators have also expressed concern that new duty hour restrictions limit clinical exposure to critically ill patients and represent an additional challenge to resident competence. 3,4 Simulation-based education improves trainees' knowledge and skills in areas such as invasive procedures, [5][6][7][8][9] communication skills, 10 and management of medical emergencies.…”

Section: Introductionmentioning

confidence: 99%

Retention of Critical Care Skills After Simulation-Based Mastery Learning

Moazed¹,

Cohen²,

Furiasse³

et al. 2013

Journal of Graduate Medical Education

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Background Whether cognitive and patient care skills attained during simulation-based mastery learning (SBML) are retained is largely unknown. Objective We studied retention of intensive care unit (ICU) clinical skills after an SBML boot camp experience. Methods Forty-seven postgraduate year (PGY)-1 residents completed SBML intervention designed to increase procedural, communication, and patient care skills. The intervention included ICU skills such as ventilator and hemodynamic parameter management. Residents were required to meet or exceed a minimum passing score (MPS) on a clinical skills examination before starting actual patient care. Skill retention was assessed in 42 residents who rotated in the medical ICU. Residents received a standardized 15-minute booster teaching session reviewing key concepts during the first week of the rotation. During the fourth week of their rotation, PGY-1 residents completed a clinical skills examination at the bedside of an actual ICU patient. Group mean examination scores and the proportion of subjects who met or exceeded the MPS at each testing occasion were compared. Results Residents scored a mean 90% (SD = 6.5%) on the simulated skills examination immediately after training. Residents retained skills obtained through SBML as the mean score at bedside follow-up testing was 89% (SD = 8.9%, P = .36). Thirty-seven of 42 (88%) PGY-1 residents met or exceeded the MPS at follow-up. Conclusion SBML leads to substantial retention of critical care knowledge, and patient care skills PGY-1 boot camp is a highly efficient and effective model that can be administered at the beginning of the academic year.

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Section: Introductionmentioning

confidence: 99%

Retention of Critical Care Skills After Simulation-Based Mastery Learning

Moazed¹,

Cohen²,

Furiasse³

et al. 2013

Journal of Graduate Medical Education

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“…HFOV avoids high peak inspiratory pressures, thus preventing end-inspiratory overdistension, and it avoids repetitive recruitment and de-recruitment of the unstable lung alveoli, thus preventing end-expiratory collapse [1-3]. Despite these factors, HFOV is primarily used as a rescue therapy in pediatric patients with diffuse alveolar disease (DAD), and the reported survival varies between 18% and 67% [4-15]. …”

Section: Introductionmentioning

confidence: 99%

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et al. 2005

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“…internal medicine residents are not gaining important evidence-based knowledge needed to provide effective care for patients who require mechanical ventilation." 24 So how do instruction programs deal with the challenge? We recently conducted an informal survey of members of the AARC specialty section on education.…”

Section: The Problem Of Teaching Mechanical Ventilationmentioning

confidence: 99%

A Taxonomy for Mechanical Ventilation: 10 Fundamental Maxims

2014

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The American Association for Respiratory Care has declared a benchmark for competency in mechanical ventilation that includes the ability to "apply to practice all ventilation modes currently available on all invasive and noninvasive mechanical ventilators." This level of competency presupposes the ability to identify, classify, compare, and contrast all modes of ventilation. Unfortunately, current educational paradigms do not supply the tools to achieve such goals. To fill this gap, we expand and refine a previously described taxonomy for classifying modes of ventilation and explain how it can be understood in terms of 10 fundamental constructs of ventilator technology: (1) defining a breath, (2) defining an assisted breath, (3) specifying the means of assisting breaths based on control variables specified by the equation of motion, (4) classifying breaths in terms of how inspiration is started and stopped, (5) identifying ventilator-initiated versus patient-initiated start and stop events, (6) defining spontaneous and mandatory breaths, (7) defining breath sequences (8), combining control variables and breath sequences into ventilatory patterns, (9) describing targeting schemes, and (10) constructing a formal taxonomy for modes of ventilation composed of control variable, breath sequence, and targeting schemes. Having established the theoretical basis of the taxonomy, we demonstrate a step-by-step procedure to classify any mode on any mechanical ventilator.

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Effectiveness of Medical Resident Education in Mechanical Ventilation

Cited by 70 publications

References 28 publications

Retention of Critical Care Skills After Simulation-Based Mastery Learning

Retention of Critical Care Skills After Simulation-Based Mastery Learning

Untitled

A Taxonomy for Mechanical Ventilation: 10 Fundamental Maxims

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