Yee Jennifer, Fuenning Charles, George Richard, Hejal Rana, Haines Nhi, Dunn Diane, Gothard M David, Ahmed Rami A
Summa Health System Akron City Hospital, Akron, OH 44304, USA; Northeast Ohio Medical University, Rootstown, OH 44272, USA; Western Reserve Hospital, Cuyahoga Falls, OH 44223, USA.
Summa Health System Akron City Hospital, Akron, OH 44304, USA; Northeast Ohio Medical University, Rootstown, OH 44272, USA.
Crit Care Res Pract. 2016;2016:4670672. doi: 10.1155/2016/4670672. Epub 2016 Feb 1.
Objectives. Management of mechanically ventilated patients may pose a challenge to novice residents, many of which may not have received formal dedicated critical care instruction prior to starting their residency training. There is a paucity of data regarding simulation and mechanical ventilation training in the medical education literature. The purpose of this study was to develop a curriculum to educate first-year residents on addressing and troubleshooting ventilator alarms. Methods. Prospective evaluation was conducted of seventeen residents undergoing a twelve-hour three-day curriculum. Residents were assessed using a predetermined critical action checklist for each case, as well as pre- and postcurriculum multiple-choice cognitive knowledge questionnaires and confidence surveys. Results. Significant improvements in cognitive knowledge, critical actions, and self-reported confidence were demonstrated. The mean change in test score from before to after intervention was +26.8%, and a median score increase of 25% was noted. The ARDS and the mucus plugging cases had statistically significant improvements in critical actions, p < 0.001. A mean increase in self-reported confidence was realized (1.55 to 3.64), p = 0.049. Conclusions. A three-day simulation curriculum for residents was effective in increasing competency, knowledge, and confidence with ventilator management.
目标。对机械通气患者的管理可能会给新手住院医师带来挑战，其中许多人在开始住院医师培训之前可能没有接受过正规的重症监护专门指导。医学教育文献中关于模拟和机械通气培训的数据很少。本研究的目的是制定一门课程，以教育一年级住院医师如何处理呼吸机警报及排除故障。方法。对17名接受为期三天、共12小时课程培训的住院医师进行前瞻性评估。针对每个病例，使用预先确定的关键行动清单对住院医师进行评估，并在课程前后进行多项选择认知知识问卷和信心调查。结果。认知知识、关键行动和自我报告的信心均有显著提高。干预前后测试成绩的平均变化为+26.8%，中位数得分提高了25%。急性呼吸窘迫综合征（ARDS）和黏液堵塞病例的关键行动有统计学上的显著改善，p<0.001。自我报告的信心平均有所提高（从1.55提高到3.64），p = 0.049。结论。为住院医师开设的为期三天的模拟课程有效地提高了他们在呼吸机管理方面的能力、知识和信心。
