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Jornal Brasileiro de Pneumologia

Print version ISSN 1806-3713On-line version ISSN 1806-3756

Abstract

HAYASHI, Fátima Kiyoko et al. Impact of a respiratory ICU rotation on resident knowledge and confidence in managing mechanical ventilation. J. bras. pneumol. [online]. 2020, vol.46, n.5, e20190108.  Epub June 15, 2020. ISSN 1806-3756.  https://doi.org/10.36416/1806-3756/e20190108.

Objective:

To develop and apply a competency-based test to assess learning among internal medicine residents during a respiratory ICU rotation at a university hospital.

Methods:

We developed a test comprising 19 multiple-choice questions regarding knowledge of mechanical ventilation (MV) and 4 self-assessment questions regarding the degree of confidence in the management of MV. The test was applied on the first and last day of a 30-day respiratory ICU rotation (pre-rotation and post-rotation, respectively). During the rotation, the residents had lectures, underwent simulator training, and shadowed physicians on daily bedside rounds focused on teaching MV management.

Results:

Fifty residents completed the test at both time points. The mean score increased from 6.9 ± 1.2 (pre-rotation) to 8.6 ± 0.8 (post-rotation; p < 0.001). On questions regarding the approach to hypoxemia, the recognition of patient-ventilator asynchrony, and the recognition of risk factors for extubation failure, the post-rotation scores were significantly higher than the pre-rotation scores. Confidence in airway management increased from 6% before the rotation to 22% after the rotation (p = 0.02), whereas confidence in making the initial MV settings increased from 31% to 96% (p < 0.001) and confidence in adjusting the ventilator modes increased from 23% to 77% (p < 0.001).

Conclusions:

We developed a competency-based test to assess knowledge of MV among residents before and after an rotation in a respiratory ICU. Resident performance increased significantly after the rotation, as did their confidence in caring for patients on MV.

Keywords : Education, medical; Respiration, artificial; Surveys and questionnaires; internship and residency; Competency-based education; Educational measurement.

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