Telepresent mechanical ventilation training versus traditional instruction: a simulation-based pilot study
critical care; education; telepresence; simulation; Health Care Sciences & Services; telementoring; mechanical ventilation; society; critical-care medicine; DASH
Background Mechanical ventilation is a complex topic that requires an in-depth understanding of the cardiopulmonary system, its associated pathophysiology and comprehensive knowledge of equipment capabilities. Introduction The use of telepresent faculty to train providers in the use of mechanical ventilation using medical simulation as a teaching methodology is not well established. The aim of this study was to compare the efficacy of telepresent faculty versus traditional in-person instruction to teach mechanical ventilation to medical students. Materials and methods Medical students for this small cohort pilot study were instructed using either in-person instruction or telementoring. Initiation and management of mechanical ventilation were reviewed. Effectiveness was evaluated by pre- and post-multiple choice tests, confidence surveys and summative simulation scenarios. Students evaluated faculty debriefing using the Debriefing Assessment for Simulation in Healthcare Student Version (DASH-SV). Results A 3-day pilot curriculum demonstrated significant improvement in the confidence (in person P<0.001; telementoring P=0.001), knowledge (in person P<0.001; telementoring P=0.022) and performance (in person P<0.001; telementoring P<0.002) of medical students in their ability to manage a critically ill patient on mechanical ventilation. Participants favoured the in-person curriculum over telepresent education, however, resultant mean DASH-SV scores rated both approaches as consistently to extremely effective. Discussion While in-person learners demonstrated larger confidence and knowledge gains than telementored learners, improvement was seen in both cases. Learners rated both methods to be effective. Technological issues may have contributed to students providing a more favourable rating of the in-person curriculum. Conclusions Telementoring is a viable option to provide medical education to medical students on the fundamentals of ventilator management at institutions that may not have content experts readily available.
Ciullo A; Yee J; Frey J A; Gothard M D; Benner A; Hammond J; Ballas D; Ahmed R A
Bmj Simulation & Technology Enhanced Learning
2019
2019-01
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1136/bmjstel-2017-000254" target="_blank" rel="noreferrer noopener">10.1136/bmjstel-2017-000254</a>
Simulation-based interprofessional conference: a focus on patient handoffs and critical communication
communication; handoff; interprofessional; simulation
October 2019 Update
Gable Brad; Ahmed Rami
Bmj Simulation & Technology Enhanced Learning
2019
2019-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1136/bmjstel-2017-000260" target="_blank" rel="noreferrer noopener">10.1136/bmjstel-2017-000260</a>
Medical judgement analogue studies with applications to spaceflight crew medical officer.
Astronaut Health; Clinical Judgement; Decision-making; Medical Judgement; Simulation
Background: The National Aeronautics and Space Administration (NASA) developed plans for potential emergency conditions from the Exploration Medical Conditions List. In an effort to mitigate conditions on the Exploration Medical Conditions List, NASA implemented a crew medical officer (CMO) designation for eligible astronauts. This pilot study aims to add knowledge that could be used in the Integrated Medical Model. Methods: An analogue population was recruited for two categories: administrative physicians (AP) representing the physician CMOs and technical professionals (TP) representing the non-physician CMOs. Participants completed four medical simulations focused on abdominal pain: cholecystitis (CH) and renal colic (RC) and chest pain: cardiac ischaemia (STEMI; ST-segment elevation myocardial infarction) and pneumothorax (PX). The Medical Judgment Metric (MJM) was used to evaluate medical decision making. Results: There were no significant differences between the AP and TP groups in age, gender, race, ethnicity, education and baseline heart rate. Significant differences were noted in MJM average rater scores in AP versus TP in CH: 13.0 (+/-2.25), 4.5 (+/-0.48), p=\textless0.001; RC: 12.3 (+/-2.66), 4.8 (+/-0.94); STEMI: 12.1 (+/-3.33), 4.9 (+/-0.56); and PX: 13.5 (+/-2.53), 5.3 (+/-1.01), respectively. Discussion: There could be a positive effect on crew health risk by having a physician CMO. The MJM demonstrated the ability to quantify medical judgement between the two analogue groups of spaceflight CMOs. Future studies should incorporate the MJM in a larger analogue population study to assess the medical risk for spaceflight crewmembers.
McCarroll Michele L; Ahmed Rami A; Schwartz Alan; Gothard Michael David; Atkinson Steven Scott; Hughes Patrick; Brito Jose Cepeda; Assad Lori; Myers Jerry; George Richard L
BMJ simulation & technology enhanced learning
2017
2017-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1136/bmjstel-2017-000210" target="_blank" rel="noreferrer noopener">10.1136/bmjstel-2017-000210</a>