Susan R Wilcox1, Todd A Seigel2, Tania D Strout3, Jeffrey I Schneider4, Patricia M Mitchell4, Evie G Marcolini5, Michael N Cocchi6, Howard A Smithline7, Lucienne Lutfy-Clayton7, Marie Mullen8, Jonathan S Ilgen9, Jeremy B Richards10. 1. Department of Emergency Medicine, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts. 2. Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island; University of California San Francisco, San Francisco, California. 3. Department of Emergency Medicine, Maine Medical Center, Portland, Maine. 4. Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts. 5. Department of Emergency Medicine, Yale-New Haven Hospital, New Haven, Connecticut. 6. Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Anesthesia Critical Care, Division of Critical Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts. 7. Department of Emergency Medicine, Baystate Medical Center, Springfield, Massachusetts. 8. Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts. 9. Division of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington. 10. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Abstract
BACKGROUND: Although Emergency physicians frequently intubate patients, management of mechanical ventilation has not been emphasized in emergency medicine (EM) residency curricula. OBJECTIVES: The objective of this study was to quantify EM residents' education, experience, and knowledge regarding mechanical ventilation. METHODS: We developed a survey of residents' educational experiences with ventilators and an assessment tool with nine clinical questions. Correlation and regression analyses were performed to evaluate the relationship between residents' scores on the assessment instrument and their training, education, and comfort with ventilation. RESULTS: Of 312 EM residents, 218 responded (69.9%). The overall correct response rate for the assessment tool was 73.3%, standard deviation (SD) ± 22.3. Seventy-seven percent (n = 167) of respondents reported ≤ 3 h of mechanical ventilation education in their residency curricula over the past year. Residents reported frequently caring for ventilated patients in the ED, as 64% (n = 139) recalled caring for ≥ 4 ventilated patients per month. Fifty-three percent (n = 116) of residents endorsed feeling comfortable caring for mechanically ventilated ED patients. In multiregression analysis, the only significant predictor of total test score was residents' comfort with caring for mechanically ventilated patients (F = 10.963, p = 0.001). CONCLUSIONS: EM residents report caring for mechanically ventilated patients frequently, but receive little education on mechanical ventilation. Furthermore, as residents' performance on the assessment tool is only correlated with their self-reported comfort with caring for ventilated patients, these results demonstrate an opportunity for increased educational focus on mechanical ventilation management in EM residency training.
BACKGROUND: Although Emergency physicians frequently intubate patients, management of mechanical ventilation has not been emphasized in emergency medicine (EM) residency curricula. OBJECTIVES: The objective of this study was to quantify EM residents' education, experience, and knowledge regarding mechanical ventilation. METHODS: We developed a survey of residents' educational experiences with ventilators and an assessment tool with nine clinical questions. Correlation and regression analyses were performed to evaluate the relationship between residents' scores on the assessment instrument and their training, education, and comfort with ventilation. RESULTS: Of 312 EM residents, 218 responded (69.9%). The overall correct response rate for the assessment tool was 73.3%, standard deviation (SD) ± 22.3. Seventy-seven percent (n = 167) of respondents reported ≤ 3 h of mechanical ventilation education in their residency curricula over the past year. Residents reported frequently caring for ventilated patients in the ED, as 64% (n = 139) recalled caring for ≥ 4 ventilated patients per month. Fifty-three percent (n = 116) of residents endorsed feeling comfortable caring for mechanically ventilated ED patients. In multiregression analysis, the only significant predictor of total test score was residents' comfort with caring for mechanically ventilated patients (F = 10.963, p = 0.001). CONCLUSIONS: EM residents report caring for mechanically ventilated patients frequently, but receive little education on mechanical ventilation. Furthermore, as residents' performance on the assessment tool is only correlated with their self-reported comfort with caring for ventilated patients, these results demonstrate an opportunity for increased educational focus on mechanical ventilation management in EM residency training.
Authors: Jonathan M Keller; Dru Claar; Juliana Carvalho Ferreira; David C Chu; Tanzib Hossain; William Graham Carlos; Jeffrey A Gold; Stephanie A Nonas; Nitin Seam Journal: J Grad Med Educ Date: 2019-08
Authors: Gabriel Wardi; Ian Joel; Julian Villar; Michael Lava; Eric Gross; Vaishal Tolia; Raghu R Seethala; Robert L Owens; Rebecca E Sell; Sydney B Montesi; Farbod N Rahaghi; Somnath Bose; Ashish Rai; Elizabeth K Stevenson; Jakob McSparron; Vaishal Tolia; Jeremy R Beitler Journal: J Intensive Care Med Date: 2019-08-25 Impact factor: 2.889
Authors: Lauren B Angotti; Jeremy B Richards; Daniel F Fisher; Jeffrey D Sankoff; Todd A Seigel; Haitham S Al Ashry; Susan R Wilcox Journal: West J Emerg Med Date: 2017-07-11
Authors: Susan R Wilcox; Tania D Strout; Jeffrey I Schneider; Patricia M Mitchell; Jessica Smith; Lucienne Lutfy-Clayton; Evie G Marcolini; Ani Aydin; Todd A Seigel; Jeremy B Richards Journal: West J Emerg Med Date: 2016-04-26