‘Involve me and I learn’: an experiential teaching approach to improve dyspnea awareness in medical residents

Abstract

Background Dyspnea is a frightening and debilitating experience. It attracts less attention than pain (‘dyspnea invisibility’), possibly because of its non-universal nature. We tested the impact of self-induced experimental dyspnea on medical residents. Materials and Methods During a teaching session following the principles of experiential learning, emergency medicine residents were taught about dyspnea theoretically, observed experimental dyspnea in their teacher, and personally experienced self-induced dyspnea. The corresponding psychophysiological reactions were described. Immediate and 1-year evaluations were conducted to assess course satisfaction (overall 0–20 grade) and the effect on the understanding of what dyspnea represents for patients. Results Overall, 55 emergency medicine residents participated in the study (26 men, median age 26 years). They were moderately satisfied with previous dyspnea teaching (6 [5–7] on a 0–10 numerical rating scale [NRS]) and expressed a desire for an improvement in the teaching (8 [7–9]). Immediately after the course they reported improved understanding of patients’ experience (7 [6–8]), which persisted at 1 year (8 [7–9], 28 respondents). Overall course grade was 17/20 [15–18], and there were significant correlations with experimental dyspnea ratings (intensity: r = 0.318 [0.001–0.576], p = 0.043; unpleasantness: r = 0.492 [0.208–0.699], p = 0.001). In multivariate analysis, the only factor independently associated with the overall course grade was ‘experiential understanding’ (the experimental dyspnea-related improvement in the understanding of dyspneic patients’ experience). A separate similar experiment conducted in 50 respiratory medicine residents yielded identical results. Conclusions This study suggests that, in advanced medical residents, the personal discovery of dyspnea can have a positive impact on the understanding of what dyspnea represents for patients. This could help fight dyspnea invisibility.

Patient education about breathlessness

“…Decavèle and colleagues 48▪▪ delivered a 90-min comprehensive experiential education session to 55 emergency medicine residents. This session included dyspnoea theory and opportunities to (1) observe experimentally induced dyspnoea in their teacher and (2) personally experience dyspnoea, induced experimentally by CO 2 rebreathing, inspiratory threshold loading or straw breathing.…”

From the sound of breathing to the sound of distress: implications for dyspnoeic patients and their caregivers

“…Indeed, many healthcare professionals are repeatedly exposed to dyspnea and have an ethical and moral duty to do their maximum to relieve it in their patients [21]. To meet this obligation, they must learn to identify dyspnea, train to manage it, and understand what it represents for their patients [22]. They must also learn to harness their dyspnea-induced empathetic resonance.…”

Graphic Novels and Comics in Undergraduate and Graduate Medical Students Education: A Scoping Review

“…It emphasizes practical application of knowledge, reflection, and active involvement with clinical events and scenarios as important parts of medical education. EL closes the gap between theory and practice through interaction with patients, work in clinical settings, simulation, role playing, and community-based experience [1][2][3][4].…”