The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

A RESPIRATORY CARE SIMULATION EXPERIENCE

P. A. Achuff1, R. Hales1, R. Matthews1, L. Soorikian1, A. Hedgman1, E. Dantzler1, W. Freitag1, J. Orkin1

Background: Respiratory Therapists (RTs), specializing in pediatrics, often experience novel situations for which they received insufficient training during respiratory school and clinical orientations. To address these experiential gaps, an educational needs assessment survey was conducted within the Department of Respiratory Care. Staff identified a need for increased education. High Frequency Oscillatory Ventilation (HFOV) was the first topic selected based upon the assessment. An attempt was made to accommodate kinesthetic learners using simulation.

Method: Specific learning objectives for HFOV were developed. The two-step process consisted of non-traditional (didactic) and traditional (simulation) programs approved by the AARC for Continuing Respiratory Education (CRCE). All participants were provided advance didactic material and a pre-test. A staff core group developed the pediatric case scenario and was trained as simulation facilitators. Each 30-minute session included 2-3 participants and 2 facilitators. An anonymous program evaluation, using a 5-point scale, analyzed facilitator teaching effectiveness. A 4-point scale analyzed achievement of educational objectives. After two months, all participants completed a post-test to evaluate retention of key educational points and improvement percentage compared with pre-test scores.

Results: 101 RTs completed the HFOV simulation program. Facilitator teaching effectiveness scored 4.44 (excellent) and achievement of educational objectives scored 3.4 (agree). Post-test scores improved 3.38% from pre-test scores. Post-test scores showed ≥88% retention of key educational points for 11 of 12 questions.

Conclusion: We did not see a significant improvement in post-test scores. Some contributing factors may have been: lack of time for debriefing, inadequate facilitator preparation/training, and pre-test content inconsistent with pre-course materials. Additional reasons may include participant’s lack of familiarity with simulation format and long training days resulting in facilitator fatigue. After evaluating these findings, changes to material, training and timing were applied to the next simulation session.

Retention Table
Key words to post-test question Correct Response Incorrect Response
Patient circuit calibration 89% 11%
Goals of HFOV in RDS 95% 5%
HFOV goals in weaning 97% 3%
Function of RESET button 95% 5%
Inline suction 97% 3%
Initial CXR time 90% 10%
Power/amplitude adjustment 98% 2%
MAP and pneumothorax 74% 26%
Chest auscultation 88% 12%
Transitioning from conventional 89% 11%
Need for volume/vasopressor 96% 4%
Description of hemodynamic response 92% 8%

Based on 97 completed post-tests


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