Table 1.
EM Physician Performance at Baseline, One‐week After, and 8 Months After the Educational Intervention With p‐values
| OSCE Task | Baseline, % success | One Week post, % success (p‐value) | Eight Months Post, % Success (p‐value) |
|---|---|---|---|
| Powers on ventilator | 77% | 100% (0.0170) | 100% (0.0170) |
| Connects oxygen source | 32% | 95% (<0.0001) | 100% (<0.0001) |
| Sets proper ventilator mode (volume or pressure control acceptable) | 68% | 95% (0.0186) | 100% (0.0186) |
| Sets proper rate: 12–20 lung‐protective strategy (every case other than obstructive cases), 6–10 obstructive strategy (asthma/COPD) | 32% | 86% (<0.0001) | 100% (<0.0001) |
| Sets proper tidal volume: 6–8 mL/kg IBW (if PC using pressure to deliver appropriate volume by IBW) | 9% | 86% (<0.0001) | 86% (<0.0001) |
| Sets proper PEEP: 5–10 cm H2O initially for lung‐protective, 0–5 cm H2O for obstructive | 32% | 100% (<0.0001) | 100% (<0.0001) |
| Sets proper pressure support (assure proper volume (by IBW) delivered if using pressure control, if using volume correctly give full credit) | 14% | 86% (<0.0001) | 100% (<0.0001) |
| Sets proper FiO2 (once intubated should titrate down to 30%–50% and titrate based on FiO2) | 36% | 95% (<0.0001) | 100% (<0.0001) |
| Connects patient to the circuit (actually hooking up the ventilator to the patient/test lung) | 36% | 100% (<0.0001) | 100% (<0.0001) |
| Adequately troubleshoots alarms | 0% | 82% (<0.0001) | 69% (<0.0001) |
This table illustrates the performance of our EM physicians on the OSCE at baseline, 1 week after, and 8 months after the in situ simulation educational intervention.
COPD = chronic obstructive pulmonary disease; IBW = ideal body weight; OSCE = observed standard clinical examination; PC = pressure controlled; PEEP = positive end expiratory pressure.