05. Behavioral Science, Epidemiologic Methods, Health Services Research

A4783 - Bridging the Gap: Pilot of a Multi-Disciplinary, Interactive Session in Hypoxemia and Respiratory Support Devices

Presenter:
Date
05/21/2019
Room
Area B (Hall F, Level 2), KBHCCD
Session Name
C40 - CRITICAL CARE: THE ART OF WAR - INNOVATIONS IN EDUCATION
Session Type
Thematic Poster Session

Abstract

Rationale: Respiratory distress and hypoxia are common inpatient scenarios encountered by residents, accounting for 16% of rapid responses1. These situations require rapid assessment and decisive management by physicians, including the use of oxygenation or ventilation support devices. First-year residents often feel uneasy about managing acutely hypoxemic patients, particularly because exposure to respiratory support devices is not a common aspect of core medical education. To address this we designed an interactive, multi-disciplinary module to both educate residents about acute hypoxemia and provide hands-on experience with oxygenation and ventilation devices.Methods: We created the educational session in collaboration with a Respiratory Therapist, targeted specifically to first-year residents on an Internal Medicine inpatient rotation. It was delivered to a convenience sample of first-year residents attending a sixty minute intern-only inpatient conference. Participants completed a pre-test consisting of questions about comfort with hypoxemic patients and oxygenation/ventilation delivery devices, and were split into two groups. The first group underwent an interactive “chalk-talk” about management of acutely hypoxemic patients. The second group received hands-on, practical experience with different respiratory support devices under the guidance of a Respiratory Therapist. Halfway through, the groups switched stations to receive both parts of the session. Participants then completed a post-test with the same questions about comfort with the material.Results: Of those who completed the pre-test (n=9), 44% were somewhat or very uncomfortable with patients in hypoxemic respiratory failure, and 56% were either somewhat or very uncomfortable with different oxygenation or ventilation devices. No interns surveyed felt somewhat or very comfortable with either subject, while 55% and 33% respectively were neutral. Conversely, of the interns who completed the post-survey (n=12), 92% felt somewhat or very comfortable with hypoxemic patients, while 83% felt similarly about oxygenation and ventilation devices. No residents surveyed felt somewhat or very uncomfortable with either topic, while 8% and 17% felt neutral about the respective areas.Conclusions: Based on the results of this pilot study, there was a noticeable increase in the level of comfort perceived by interns in both hypoxemic respiratory failure and the devices used in management. While the pilot was of small sample size and focused on reaction outcomes, this is suggestive that continued modules utilizing a multidisciplinary, synergistic approach combining diagnostic reasoning with exposure to practical tools could be of considerable benefit. Further sessions will expand on this foundation with additional perception-based questions, and include cased-based questions to assess changes in knowledge.
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