• Chest · Mar 2024

    Creation and validation of a massive hemoptysis simulator.

    • Melissa L New, Timothy Amass, Anna Neumeier, Nicholas M Jacobson, and Tristan J Huie.
    • Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Aurora, CO; Rocky Mountain Regional VA Medical Center, Aurora, CO. Electronic address: Melissa.New@cuanschutz.edu.
    • Chest. 2024 Mar 1; 165 (3): 636644636-644.

    BackgroundSimulation for the management of massive hemoptysis is limited by the absence of a commercially available simulator to practice procedural skills necessary for management.Research QuestionIs it feasible to create and validate a hemoptysis simulator with high functional task alignment?Study Design And MethodsPulmonary and critical care medicine (PCCM) attending physicians from four academic institutions in the Denver, Colorado, area and internal medicine residents from the University of Colorado participated in this mixed-methods study. A hemoptysis simulator was constructed by connecting a 3-D-printed airway model to a manikin that may be intubated. Attending PCCM physicians evaluated the simulator through surveys and qualitative interviews. Attendings were surveyed to determine simulation content and appropriate assessment criteria for a hemoptysis simulation. Based on these criteria, expert and novice performance on the simulator was assessed.ResultsThe manikin-based hemoptysis simulator demonstrated adequate physical resemblance, high functional alignment, and strong affective fidelity. It was universally preferred over a virtual reality simulator by 10 PCCM attendings. Twenty-seven attendings provided input on assessment criteria and established that assessing management priorities (eg, airway protection) was preferred to a skills checklist for hemoptysis management. Three experts outperformed six novices in hemoptysis management on the manikin-based simulator in all management categories assessed, supporting construct validity of the simulation.InterpretationCreation of a hemoptysis simulator with appropriate content, high functional task alignment, and strong affective fidelity was successful using 3-D-printed airway models and existing manikins. This approach can overcome barriers of cost and availability for simulation of high-acuity, low-occurrence procedures.Published by Elsevier Inc.

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