2002 OPEN FORUM Abstracts
ONGOING RESPIRATORY CARE PRACTITIONER EDUCATION: EVALUATION OF A MECHANICAL VENTILATION LEARNING LABORATORY
Julie Harrison, RRT; Dawn Selhorst, RRT; Scott Penfil, MD; Edward Cullen, DO; John Rendle, RRT; James Hertzog, MD. Departments of Respiratory Care Services and Anesthesiology and Critical Care Medicine, Alfred I. duPont Hospital for Children, Wilmington, DE.
Introduction: Teaching and evaluating clinical knowledge, skill, and problem solving should include didactic and interactive activities. We developed a Mechanical Ventilation Learning Laboratory, hypothesizing that Respiratory Care Practitioner (RCP) knowledge and ability in the principles and application of mechanical ventilatory support to children would be enhanced.
Methods: A dedicated space, separated from clinical activities, was established for this project. In this laboratory, equipment is available to simulate the process of mechanical ventilation, including a mechanical ventilator and a Michigan test lung. A RCP participated in an individualized session using the Siemans Servo 300 ventilator with a Respiratory Care Clinical Instructor and a Pediatric Intensivist. A written examination about the function of this ventilator and a series of Likert scored questions on RCP impressions regarding their experience, ability, and comfort level with the ventilator was completed. A modified objective structured clinical exam (OSCE) was then performed, testing functional abilities with the ventilator, problem solving abilities, and knowledge of advanced respiratory care concepts (?pre?). An educational intervention was then performed, including review of the written exam and OSCE. A study period of up to 30 minutes was provided where the RCP could use the resources of the laboratory as they wished. Finally, all testing was repeated at the end of the study period (?post?) and approximately 3 months after initial testing. Statistical testing with General Linear Model, paired sample t test, and Wilcoxon Signed Ranks test were performed to evaluate changes in test scores and responses over time.
Results: 30 RCPs participated in the study. There is statistically significant improvement (p < 0.001) in performance of the written exam and the OSCE after education that persisted through 3 months, although there is a drop-off in performance.
|Written||Mean Score ± SD|
|Pre||10.8 ± 4.8|
|Post||23.1 ± 5.8|
|3 months||17.3 ± 7.4|
|OSCE||Mean Score ± SD|
|Pre||47.4 ± 6.8|
|Post||58.9 ± 6.7|
|3 months||50.3 ± 8.4|
Likert scored questions regarding RCP impressions demonstrated a statistically significant improvement after the educational intervention in the RCP level of comfort and confidence with setting up and using the Servo 300 as well as with understanding advanced ventilatory strategies (i.e. PRVC, inverse I: E ratio, lung protective strategies).
Conclusions: The Mechanical Ventilation Learning Laboratory proved to enhance the knowledge and ability of the RCP in the principles and application of mechanical ventilatory support to children. A drop-off in performance occurred with time, suggesting that ongoing training sessions might be necessary to maintain the RCP knowledge base.
Supported by The Nemours Foundation Education Innovation Program Grant