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Telepresent mechanical ventilation training versus traditional instruction: a simulation-based pilot study
  1. Anna Ciullo1,
  2. Jennifer Yee2,3,
  3. Jennifer A Frey2,3,
  4. M David Gothard4,
  5. Alma Benner2,
  6. Jared Hammond2,
  7. Derek Ballas2,5,
  8. Rami A Ahmed2,5
    1. 1 Department of Emergency Medicine, Summa Health, Akron, Ohio, USA
    2. 2 Department of Medical Education, Summa Health, Akron, Ohio, USA
    3. 3 Department of Emergency Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
    4. 4 Biostats, Inc., Canton, Ohio, USA
    5. 5 Northeast Ohio Medical University, Rootstown, Ohio, USA
    1. Correspondence to Dr Jennifer Yee, Department of Emergency Medicine, The Ohio State University College of Medicine, Columbus, OH 43210, USA; jennifer.yee.26{at}


    Background Mechanical ventilation is a complex topic that requires an in-depth understanding of the cardiopulmonary system, its associated pathophysiology and comprehensive knowledge of equipment capabilities.

    Introduction The use of telepresent faculty to train providers in the use of mechanical ventilation using medical simulation as a teaching methodology is not well established. The aim of this study was to compare the efficacy of telepresent faculty versus traditional in-person instruction to teach mechanical ventilation to medical students.

    Materials and methods Medical students for this small cohort pilot study were instructed using either in-person instruction or telementoring. Initiation and management of mechanical ventilation were reviewed. Effectiveness was evaluated by pre- and post-multiple choice tests, confidence surveys and summative simulation scenarios. Students evaluated faculty debriefing using the Debriefing Assessment for Simulation in Healthcare Student Version (DASH-SV).

    Results A 3-day pilot curriculum demonstrated significant improvement in the confidence (in person P<0.001; telementoring P=0.001), knowledge (in person P<0.001; telementoring P=0.022) and performance (in person P<0.001; telementoring P<0.002) of medical students in their ability to manage a critically ill patient on mechanical ventilation. Participants favoured the in-person curriculum over telepresent education, however, resultant mean DASH-SV scores rated both approaches as consistently to extremely effective.

    Discussion While in-person learners demonstrated larger confidence and knowledge gains than telementored learners, improvement was seen in both cases. Learners rated both methods to be effective. Technological issues may have contributed to students providing a more favourable rating of the in-person curriculum.

    Conclusions Telementoring is a viable option to provide medical education to medical students on the fundamentals of ventilator management at institutions that may not have content experts readily available.

    • simulation
    • telementoring
    • mechanical ventilation
    • critical care
    • DASH
    • telepresence

    Statistics from


    • Contributors AC monitored data collection, analysed the data, and drafted and revised the paper. JY designed data collection tools, monitored data collection, analysed the data, and drafted and revised the paper. She is guarantor. JAF cleaned the data, drafted and revised the paper. MDG wrote the statistical analysis plan, cleaned and analysed the data, and revised the paper. AB monitored data collection and revised the paper. JH monitored data collection and revised the paper. DB monitored data collection and drafted and revised the paper. RAA designed data collection tools, analysed the data, and drafted and revised the paper. AC, JY, AB, JH, DB and RAA implemented the trial in the USA.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Ethics approval Summa institutional review board.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement There are no additional unpublished data.

    • Collaborators Charles R Fuenning; Richard L George.

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