Development and implementation of a simulation-based training program for management of Acute Respiratory Failure (ARF) in respiratory Intensive Care Unit (ICU)

Abstract

Background: Many medical institutes and centers employ simulation in medical education, however, there is still limited experience regarding its use, especially in low–middle-income countries such as Egypt. Objective: We conducted this work to investigate the effectiveness of simulation-based training (SBT) as an educational tool for teaching pulmonary-medicine postgraduate students the ICU management of acute respiratory failure (ARF). Patients and methods: Thirty postgraduate students enrolled in the Master of Pulmonary Medicine at Ain Shams School of Medicine without previous experience in SBT were randomly categorized into two groups (1 : 1), namely SBT and lecture-based training in the period between January 2019 and January 2020. Both groups attended lectures on management of ARF in ICU patients; however, the SBT group received additional SBT. We assessed clinical knowledge after the lectures with multiple-choice written exams. The SBT group received the same exams after simulation to assess its impact in addition to a satisfaction survey. The ventilator skills of the SBT team were evaluated after a video presentation of the ventilator chart recorded in a real case using a 12-item checklist before and after simulation training. Results: Total knowledge scores of all scenarios were almost similar between the two groups at baseline (SBT: 56.6 vs. 55.2, P=0.581). Simulation training significantly improved the total knowledge score of the SBT group, compared with the presimulation score (56.6 vs. 69.4, P≤0.001) and the lecture-based training group (69.4 vs. 55.2, P≤0.001). Compared with baseline, the SBT group’s skill score significantly increased after simulation (46.9 vs. 65.6, P≤0.001). The improvement in knowledge and skills scores was independent of baseline knowledge score, age, and years of experience, except for the acute-asthma scenario. All SBT participants were either very satisfied (86.7%) or satisfied (13.3%). It should be noted that satisfaction with this type of training was not correlated with the sociodemographic characteristics of the participants. Most of the candidates (80.7%) believe that such training has successfully improved their communication skills.