The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

SIMULATION IN RESPIRATORY CRITICAL CARE AND EXTRACORPOREAL MEMBRANE OXYGENATION

Michael Minneti, Eryn Miller, Lara P. Nelson; University of Minnesota Medical Center, Fairview, Minneapolis, MN

Background: Traditional approach to continued medical education for respiratory critical care and Extracorporeal membrane oxygenation (ECMO) training focuses on didactic teaching. Afterward, staff are assigned to preceptors to demonstrate their critical thinking skills as opportunities arise. This model is limiting because it relies on unfavorable events occurring for staff to demonstrate competence and receive evaluation of their actions. Staff may finish training without having proved their ability to react appropriately in emergencies. The Respiratory Care Department at University of Minnesota Medical Center created a simulation lab to address these limitations. Methods: An infant CPR manikin was adapted to resemble an ICU or ECMO patient and connected to appropriate monitoring equipment. Physiologic variables can be modified based on the learners’ interactions with the environment, such as: vital signs, symmetry of breath sounds and chest rise, ventilator pressures, chest tube output, endotracheal tube complications, and ECMO circuit dynamics. Critical care and ECMO scenarios were developed to test staffs’ reactions to emergencies. The scenarios were video recorded and the learners’ critical thinking skills were evaluated by the instructor. Substantative feedback was provided in the debriefing period immediately following the scenario. Results: Seventeen learners each completed three scenarios. Upon conclusion learners completed an evaluation form. Overall the participants felt the experience was beneficial. Questions about the scenarios and debriefings used a 5-point Likert scale with 1 = poor and 5 = excellent. Cumulative scores showed a mean score of 4.7 for the scenarios (SD=0.5) and a mean score of 4.8 for the debriefings (SD=0.4). In addition, the instructor also felt he was able to create “real” scenarios that tested critical thinking skills of staff and provide feedback to staff based on his observations. Conclusion: Creation of a simulated critical care environment provides respiratory therapists and ECMO specialists guaranteed exposure to high risk scenarios that test behavioral and technical skills. Through interaction in the simulated environment instructors have a means to assess competence and give substantative feedback to staff. Sponsored Research - None

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