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Comparative Study Controlled Clinical Trial
Comparison of Web-Based and On-Site Lung Simulators for Education in Mechanical Ventilation.
- Sami Safadi, Megan Acho, Stephanie I Maximous, Michael B Keller, Eric Kriner, Christian J Woods, Junfeng Sun, Bashar S Staitieh, Burton W Lee, Nitin Seam, and Critical Care Education Research Consortium.
- Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, Minnesota. Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota, Minneapolis, Minnesota. safad002@umn.edu.
- Respir Care. 2024 Oct 25; 69 (11): 135313601353-1360.
BackgroundTraining in mechanical ventilation is a key goal in critical care fellowship education. Web-based simulators offer a cost-effective and readily available alternative to traditional on-site simulators. However, it is unclear how effective they are as teaching tools. In this study, we evaluated the test scores of fellows who underwent mechanical ventilation training by using a web-based simulator compared with fellows who used an on-site simulator during a mechanical ventilation course.MethodsThis was a nonrandomized controlled trial conducted as part of a mechanical ventilation course that involved 70 first-year critical care fellows. The course was identical except for the simulation technology used. One group of instructors used a traditional on-site simulator, the ASL 5000 Lung Solution (n = 39). The second group was instructed in using a web-based simulator, VentSim (n = 31). Each fellow completed a pre-course test and a post-course test by using a validated, case-based ventilator waveform examination that consisted of 5 questions with a total possible score of 100. The primary outcome was a comparison of the mean scores on the posttest between the 2 groups. The study was designed as a non-inferiority trial with a predetermined margin of 10 points.ResultsThere was no significant difference in the mean ± SD pretest scores between the web-based and the on-site groups (21.1 ± 12.6 and 26.9 ± 13.6 respectively; P = .11). The mean ± SD posttest scores were 45.6 ± 25.0 for the web-based simulator and 43.4 ± 16.5 for on-site simulator (mean difference 2.2; one-sided 95% CI -7.0 to ∞; P non-inferiority = .02 [non-inferiority confirmed]). Changes in mean ± SD scores (posttest - pretest) were 25.9 ± 20.9 for the web-based simulator and 16.5 ± 15.9 for the on-site simulator (mean difference 9.4, one-sided 95% CI 0.9 to ∞; P non-inferiority < .001 [non-inferiority confirmed]).ConclusionsIn the education of first-year critical care fellows on mechanical ventilation waveform analysis, a web-based mechanical ventilation simulator was non-inferior to a traditional on-site mechanical ventilation simulator.Copyright © 2024 by Daedalus Enterprises.
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