Annals of Tropical Medicine and Public Health
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Table of Contents   
ORIGINAL ARTICLE  
Year : 2017  |  Volume : 10  |  Issue : 5  |  Page : 1318-1321
Comparison of two educational methods, lecturing and simulation, in adherence to ventilator set guidelines among emergency medicine residents


1 Emergency Medicine Management Research Center, University of Medical Sciences, Tehran, Iran
2 Clinical Research Development Unit, Yasuj University of Medical Sciences, Yasuj, Iran

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Date of Web Publication6-Nov-2017
 

   Abstract 


Background: Due to developments in science, there is the need to develop approaches in the field of medical education. The utilization of educational technologies such as computers and instructional videos has been introduced rapidly into the education curriculum. This study compared video training tutorial method in ventilator settings with video traditional methods (lectures). Materials and Methods: In this statistical research, 33 assistant training groups lecture and video tutorial (video tutorial) were divided into two groups. The assistants in ventilator settings by observing the experimenter, the ventilators were assessed using the checklist. Research Findings: Adjusting the ventilator before and after training assistant was 13 (40%) and 18 (5.54%), respectively. However, in both groups after training, there was significant increase accuracy in the ventilator settings, but there was no significant difference between the two methods. Conclusion: The use of video tutorials and without training could be effective as attending lectures.

Keywords: E-learning, emergency medicine, health care

How to cite this article:
Saidi H, Rezai M, Mofidi M, Mosaddegh R, Riahi A, Sisakht MT. Comparison of two educational methods, lecturing and simulation, in adherence to ventilator set guidelines among emergency medicine residents. Ann Trop Med Public Health 2017;10:1318-21

How to cite this URL:
Saidi H, Rezai M, Mofidi M, Mosaddegh R, Riahi A, Sisakht MT. Comparison of two educational methods, lecturing and simulation, in adherence to ventilator set guidelines among emergency medicine residents. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Dec 11];10:1318-21. Available from: http://www.atmph.org/text.asp?2017/10/5/1318/217500



   Introduction Top


Medical education is changing, and teachers need to re-evaluate their teaching practices in medical sciences and develop innovative strategies to provide students maximum learning environment.[1] E-learning is the use of information technology for learning. E-learning educational innovation can be achieved through a variety of electronic tools (the internet, satellite, audio and video tapes, and DVDs) can be provided which should include computer-based training and the web-based training.[2] One of the main elements of the educational process is the application of modern teaching methods.[3],[4] In recent times, researchers are trying to identify teaching methods that could lead to more efficient health care.[4],[5],[6],[7] E-learning is self-learning method, which limits the time and place among the learners. Applying e-learning in medical education is now becoming an accepted approach.[8]


   Materials and Methods Top


Study design and sample

This study was a conducted controlled clinical trial and approval was given by Iran University of Medical Sciences. The study sample consisted of residents of emergency medicine Iran University of Medical Sciences. Included are those who were interested in participating in the study at the emergency medicine residency. Exclusion criteria included factors that affected learning, prior training from other source and presence of stress, or traumatic events.

The method of calculating sample size and number in this study, between 1392 and 1393 (use English year). Input assistant participated in this study. Given the number of agents assigned to the Iran University of Medical Sciences of the samples, there were cases of loss of some individuals, therefore 33 assistants were enrolled. They were randomly divided into two groups: Traditional lecturing and video teaching (video tutorial).

Implementation of activities and tools used

Subjects who qualified for the study were randomly divided into two groups: Simulation-based video training and traditional training. Data collected included demographic indices and checklist to assess the adherence to the guidelines in ventilator settings and the results recorded. Ventilator settings checklist includes 12 options which had an answer of correct or incorrect. [Figure 2] The assistants in ventilator settings were observed by the experimenter while the ventilator settings were assessed using the checklist. A total of 33 emergency medicine residents were enrolled. Of these 18 patients received were lecture while 15 received visual methods (video tutorial). Before the scheduled teaching, researchers showed how to record ventilator results to at least one of the participants in the study. In cases where the assistant of the first set and in the case of notes had done ventilator, intubated the patients entered the study and assistant in shifts because of the lack of ventilator settings by them. Then, the assistants were divided into two groups. Two sessions of 2 h as a speech (lecture) previous announcing that a total of 18 people were held for residents and the remaining 15 received a disc containing ventilator training. Within 1 month after training, all 33 subjects of the ventilator setting were measured again.
Figure 2: Compare adjust the ventilator to distinguish between correct and incorrect training methods

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Statistical analysis method

The descriptive analysis and frequency for qualitative variables were reported. In analytical techniques for measuring the qualitative variables Chi-square or Fisher Exact tests were used, and the quantitative variables were compared using a t-test or equivalent nonparametric (Mann–Whitney U-test) was conducted. To compare the before and after training in two groups paired t-test or equivalent nonparametric (Wilcoxon test) was used. The significance level of <5% is considered.

Research findings

A total of 33 emergency medicine residents were enrolled. Results of ventilator settings before starting the training were as an assistant in 13 (40%) case was correct and in 20 (60%) of ventilator settings were incorrect. [Table 2] Twenty were incorrect settings due to the wrong person was found. In two patients (6%) positive end expiratory pressure (PEEP) was set incorrectly, 11 cases (33.33%) assisted spontaneous breathing (ASB) was incorrect (often not specified), 7 (21.21%) incorrectly flow rate (low had been set), 4 (12.12%) incorrectness of the tidal volume (Vt) (a lot of), 10 (3.30%) incorrectly determine the trigger and 6 cases (18.18%), and high levels of FiO2; then, the assistants were divided into two groups. Two sessions of 2 h as a speech (lecture). At the first step, a total of 18 people were held for residents, and the remaining 15 received a disc containing ventilator training. Within 1 month after training, all 33 subjects of the ventilator setting were measured again. After training the following results: 18 (5.54%) cases were correct and in 15 (45.5%), and ventilator settings were incorrect. Fifteen was incorrect settings due to the wrong person again became clear. In two patients (6%) PEEP was set incorrectly, 6 cases (18.18%) ASB was wrong (not specified), 5 (15.15%) incorrectly flow rate (low had been set), 3 cases (1.9%) of the false Vt (a lot of), 6 (18.18%) incorrectly determine the trigger and 6 cases (18.18%), and high levels of FiO2 [Figure 1] and [Table 1].
Table 2: Comparison of ventilator settings by trained assistants to the separation of teaching methods

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Figure 1: Compare the wrong ventilator settings before and after training

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Table 1: Comparison of ventilator settings by residents before and after training

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Sedation and analgesia assistants for the administration and the arterial blood gas (ABG) after the ventilator settings were evaluated. A total of 33 assistant 17 people (51.5%) in the file had written medication orders, and 22 patients (66.7%) were also instructed the ABG (ABG timely recording and reporting that was available on the computer.) [Table 3] After 19 teaching assistant (57.57%) medication orders, were written in the records of 26 patients (78.78%) had given an order for ABG (ABG timely recording and reporting that was available on the computer.) Prescribing and record ABG difference was not significant before and after training (in order of P = 0.45 and 0.05) [Table 4].
Table 3: Comparison of ventilator settings separated by assistants after training, teaching methods

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Table 4: Medication and arterial blood gas results by speech and video

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   Discussion Top


Due to developments in science, the need for new approaches in the field of medical education and the use of educational technologies (e.g., computers and instructional videos) quickly enter the educational curriculum.[9] Emergency medicine is the main skills of specialists and assistants. Each day the number of patients intubated in the emergency department and needed to find their ventilator. Thus setting the ventilator until the patient is in the emergency department is responsible for emergency medicine specialists and assistants. Furthermore, due to lack of Intensive Care Unit beds and more durable mechanically ventilated patients in the emergency department setting will double the importance of proper ventilation. Unfortunately, surveys show that the setting of ventilator in the emergency department is not exactly according to standards. This means traditional teaching may not be able to fix the problems alone [10] but also in terms of time, human resources and organizational costly and inflexible regarding place and time are held. Among the methods of teaching, “lecturing” the most traditional training methods that are currently and despite the great progress that has been made in education as “most common” method used in training interns around the world. However, new studies have shown that some modern teaching methods, especially methods based “simulation” effectiveness of higher education and more satisfied with their learners. The optimal approach in medical education, educational interventions is based on the best available evidence. This caused the competency of medical students and as a result improves patient care and increase the level of public health.[11],[12] A study of teaching methods of ventilator settings there but studies have been conducted in other areas. Isbye et al. studied the efficacy of two BLS training method in 6-h classes and other training through a 24 min video with a simple model of education that people could take it home were compared with each other. The main finding of this study was no difference in the effectiveness of both methods in one group was given instruction in the 24-min film.[13] Todd and colleagues in a study the effect of learning through educational videos (video self-instruction) assess their cardiopulmonary resuscitation training. The film was made in 34 min with mannequin trainees were inexpensive. In this study, those who had received training through the film compared to the traditional method of teaching in class had a similar performance. In fact, 40% of trainees with instructional videos optimal efficiency or higher (competent) were compared with 16% in the traditional group.[14] In a research Mohd Saiboon et al., face-to-face teaching methods and the use of educational videos on the four skills training and basic common emergency (airway management, closing Kevlar neck, making use of the defibrillator and splints) are compared. Forty-five participant's skills are measured using Objective Structured Clinical Examination. In all four skill points, participants in both groups were similar, and there was no statistically significant difference. The authors have stated that the use of educational videos as well as face-to-face training is useful.[15]


   Conclusion Top


E-learning is the major benefits compared to traditional education. Flexibility and eliminate unnecessary trips and costly to participate in the training courses they considered most important. But this training has other advantages as follows: The e-learning training courses are available 24 h a day and the need to travel to attend classes is not a time for learning is reduced 30%–25%.[16] Furthermore, students can set the tone for learning according to their circumstances. Visual Spatial Index student in education from higher intelligence level, entries can be easier to pass quickly while the weaker students can spend more time learning the same material. This reduces stress and anxiety compared with these students attending classes due to the lack of ability of these with other students. Future studies can be more training through instructional videos on a large scale. The long-term reliability of the content taught through instructional videos compared to traditional methods should be specified. Also using computer software will be more useful to learners who have an interactive mode. It is better to provide facilities that students need to attend classes and bug fixes for bugs found by professor answer is to complete learning. In this study, two groups of assistants and teaching methods ventilator was finally achieved this result training ventilator as a separate unit made an impact in the right setting it in the emergency department and reduces errors. Errors in ventilator settings cause damage to the emergency ward patients, therefore, proper training and reduce errors in the education of residents will be critical ventilator settings. In this study, although the ventilator settings with better and more accurate training were conducted there was no difference between the two methods of lecture and video. In fact, using video tutorials and without training could be effective as of attending lectures.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

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Correspondence Address:
Mohamad Tahmasbi Sisakht
Clinical Research Development Unit, Yasuj University of Medical Sciences, Yasuj
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ATMPH.ATMPH_185_17

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