Online Learning and Residents’ Acquisition of Mechanical Ventilation Knowledge: Sequencing Matters

Abstract

Objective: Rapid advancements in medicine and changing standards in medical education require new, efficient educational strategies. We investigated whether an online intervention could increase residents’ knowledge and improve knowledge retention in mechanical ventilation when compared with a clinical rotation and whether the timing of intervention had an impact on overall knowledge gains. Design: A prospective, interventional crossover study conducted from October 2015 to December 2017. Setting: Multicenter study conducted in 33 PICUs across eight countries. Subjects: Pediatric categorical residents rotating through the PICU for the first time. We allocated 483 residents into two arms based on rotation date to use an online intervention either before or after the clinical rotation. Interventions: Residents completed an online virtual mechanical ventilation simulator either before or after a 1-month clinical rotation with a 2-month period between interventions. Measurements and Main Results: Performance on case-based, multiple-choice question tests before and after each intervention was used to quantify knowledge gains and knowledge retention. Initial knowledge gains in residents who completed the online intervention (average knowledge gain, 6.9%; sd, 18.2) were noninferior compared with those who completed 1 month of a clinical rotation (average knowledge gain, 6.1%; sd, 18.9; difference, 0.8%; 95% CI, –5.05 to 6.47; p = 0.81). Knowledge retention was greater following completion of the online intervention when compared with the clinical rotation when controlling for time (difference, 7.6%; 95% CI, 0.7–14.5; p = 0.03). When the online intervention was sequenced before (average knowledge gain, 14.6%; sd, 15.4) rather than after (average knowledge gain, 7.0%; sd, 19.1) the clinical rotation, residents had superior overall knowledge acquisition (difference, 7.6%; 95% CI, 2.01–12.97;p = 0.008). Conclusions: Incorporating an interactive online educational intervention prior to a clinical rotation may offer a strategy to prime learners for the upcoming rotation, augmenting clinical learning in graduate medical education.

Assessment of a massive open online course (MOOC) incorporating interactive simulation videos on residents’ knowledge retention regarding mechanical ventilation

“…Unlike face-to-face simulation, online education has the potential of reaching a massive number of learners. A recent study conducted on American residents rotating in Pediatric ICU showed that an online virtual mechanical ventilation simulator increased resident’s knowledge on this topic [ 24 ]. With short rotation periods, i.e.…”

Online educational interventions in pediatric intensive care medicine

“…No virtual or augmented reality interventions for healthcare professional education in pediatric intensive care were identified through this review. Three studies ( 9 , 12 , 13 ) included interventions aimed at residents rotating in the PICU, two studies ( 14 , 15 ) included interventions aimed at nurses, two studies ( 11 , 16 ) included interventions aimed at a multidisciplinary healthcare professionals, and one study ( 10 ) included an intervention aimed at transport nurses and paramedics. In terms of outcome measures analysed, the majority (6 of 8) of studies utilized participant surveys to assess satisfaction or change in attitudes ( 9 – 11 , 14 – 16 ), and nearly half (4 of 8) included pre- and post-intervention multiple-choice question tests ( 9 , 10 , 12 , 13 ).…”

Pediatric Critical Care in Resource Limited Settings—Lessening the Gap Through Ongoing Collaboration, Advancement in Research and Technological Innovations

“…Over the past decade, opportunities to share PCC educational materials and global health educational materials online have increased dramatically, again with rapid advancement during the COVID-19 pandemic. Some schools have created entire online PICU curricula ( 70 ), while others have utilized online education to augment PICU residents' understanding of certain topics (e.g., mechanical ventilation) ( 71 ). Others created online global health educational resources designed to be widely shared and used in various settings.…”