No association of training in a high-intensity protocol environment with mechanical ventilation exam score
TUESDAY, Sept. 6 (HealthDay News) -- For first-time examinees of the American Board of Internal Medicine (ABIM), training in a high-intensity ventilator protocol environment does not correlate with worse knowledge about mechanical ventilation management compared to training in a low-intensity environment, according to a study published in the Sept. 7 medical education-themed issue of the Journal of the American Medical Association.
Meeta Prasad, M.D., M.S.C.E., from the University of Pennsylvania School of Medicine in Philadelphia, and colleagues investigated the relationship between training with mechanical ventilation protocols and subsequent knowledge about ventilator management. The correlation between exposure to protocols, defined as high intensity for two or more and low intensity for zero to one protocols, and knowledge, measured by performance on examination questions, was assessed.
The investigators found that, of the 90 U.S. pulmonary and critical care fellowship programs that responded to the survey, 86, 73, and 60 percent had protocols for ventilation liberation, sedation management, and lung-protective ventilation, respectively. Of the 88 programs with 553 trainees who completed the ABIM Examination, 27, 19, 24, and 18 programs had zero, one, two, and three protocols for at least three years, respectively. Of these, 42 programs with 304 trainees were high-intensity, and 46 programs with 249 trainees were low-intensity. There was no difference in mean scores between high-intensity and low-intensity programs in bi-variable analyses, with a mean score difference of zero. There was no association of training in a high-intensity program with mechanical ventilation score in multivariable analysis.
"Clinical protocols, designed to standardize and optimize patient care, may not hinder high-quality medical education in mechanical ventilation management," the authors write.
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