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A Simulation-Based Mechanical Ventilation Curriculum for Multilevel Learners in An Internal Medicine Residency Program – A Pilot Study (1090-003851) (Research Abstract Oral: Procedure)
Start time: Monday, January 25, 2021, 8:00 AM End time: Monday, January 25, 2021, 9:00 AM Session Type: Research Abstracts (Completed Studies) Cost: $0.00
Content Category: Researcher
Hypothesis:
Internal Medicine (IM) residents currently receive mechanical ventilation (MV) education through clinical rounds in the intensive care unit (ICU) and self-directed learning. This traditional education for MV creates poor and inconsistent knowledge among residents. (1) In the US, only about 37% of the ICU patients are managed by intensivists, (2) with general internists providing most of the care to ICU patients. (3) Simulation is more effective to teach critical care knowledge and skills. (4) What is the effect of combined didactic, hands-on training, and case-based simulation on the comfort level and knowledge of MV among multilevel learners with various learning needs and clinical experience? It is hypothesized that the combined use of didactic and hands-on training followed by case-based simulation can improve the comfort level and knowledge of multilevel learner IM residents. This study aimed to evaluate multilevel learners' simulation-based MV course for IM residents.
Methods:
The study aimed to evaluate the effectiveness of multilevel learners’ MV curriculum for IM residents in improving their comfort level and knowledge. The curriculum was developed from a needs assessment survey of the IM residents and faculty consensus using a modified Delphi technique. The final curriculum has three parts 1) 15-minute “must-know” didactic MV contents, 2) 15- minute MV guided hands-on training and 3) 30-minute targeted case-based simulation for each level of learners: alarm interpretation for PGY 1, setting up the MV for PGY 2, and advanced MV concepts for PGY 3. The evaluation method has a two-fold purpose: 1) to measure the application of knowledge for each level of learners using two different sets of multiple-choice questionnaires, pre, and post-training, and 2) to determine the statistical difference between pre-and post-MV training comfort level through a questionnaire using a Likert scale. All questionnaires were administered immediately before and after training.
Results:
A total of 116 residents participated in the study (91%): PGY1 42 (33%), PGY2 42 (33%), and PGY3 43 (34%). 100% of the participating residents completed the surveys, of which only 7 (9%) had completed an IM residency in the past. The survey questionnaire evaluated the residents’ comfort level (attitude) and knowledge (cognitive). The comfort level component included (1) ordering basic parameters of ventilation changed from 5/10 to 7/10, (2) troubleshooting frequent alarms in the ventilator from 4/10 to 6/10, and (3) recognizing emergencies that need escalating from 4/10 to 7/10. In the knowledge section, gain in the correct answers was used as a metric. A mean increase of 24% was notable between pre- and post-training scores across all learners. The PGY 1 scores increased from 59% to 76% while PGY 2 showed improvement from 49% to 81% and PGY 3 climbed from 57% to 79%. The second phase is to evaluate after 6 months the comfort level and knowledge knowledge among the rising PGY 2 and 3.
Co-Presenter: Bertin Salguero, MD, Icahn School of Medicine at Mount Sinai Morningside - West About the co-presenter: Dr. Salguero was born and raised in Guatemala, where he earned his medical degree from the School of Medicine of the Francisco Marroquin University. He subsequently moved to New York to pursue his residency training in Internal Medicine in the Icahn School of Medicine in Mount Sinai Morningside - West Hospitals. His academic interests have been focused on medical education and pulmonary and critical care, focusing on pleural disease research and simulation-based mechanical ventilation training. He completed the Clinician-Educator Track from the Icahn School of Medicine and the Harvard Macy Institute Education Course Future Academic Clinician Educators, where he developed an innovative simulation-based mechanical ventilation curriculum for the medicine residents. During residency he received the Housestaff Excellence in Teaching Award and inducted into the Alpha Omega Alpha (AOA) Honor Medical Society. Currently is working as chief resident and after residency he plans to pursue a fellowship in Pulmonary and Critical Care Medicine.
Disclosure: No financial relationships with ineligible companies.
Co-Presenter: Dr. James Salonia, MD, Mount Sinai West About the co-presenter: Attending faculty in the Center for Advanced Medical Simulation (CAMS)
Disclosure: No financial relationships with ineligible companies.