Validation of simulated difficult bag-mask ventilation as a training and evaluation method for first-year internal medicine house staff.
BACKGROUND
The past decade has witnessed the increased use of patient simulation in medical training as a method to teach complex bedside skills. Although effective bag-mask ventilation (BMV) is a critical part of airway management, the quality of training in this skill has been questioned.


METHODS
First-year internal medicine house staff (novices) were used to evaluate a computerized patient simulator as a tool to teach difficult BMV. A novice group and an expert group (certified registered nurse anesthetists and anesthesiologists) were tested to validate the simulator's ability to distinguish between these 2 skill levels.


RESULTS
The difference between the novice and expert groups in the ability to perform difficult BMV was statistically significant (P < 0.0001). Brief training for novices led to a 100% pass rate and competence as measured by the simulator. Simulation training was effective in increasing the ability to ventilate a simulated difficult-to-ventilate patient (P < 0.0001).


CONCLUSIONS
This study suggests that this computerized patient simulator was validated as a simulation model for teaching difficult BMV and differentiating skill levels in BMV. Using the simulator with brief training on difficult BMV allowed new internal medicine house staff to successfully ventilate a simulated difficult patient.
Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA. pastisn@musc.edu
Nicholas J
NJ
Pastis
Peter
P
Doelken
Allison A
AA
Vanderbilt
John
J
Walker
John J
JJ
Schaefer
D000776:Anesthesiology / Q000193:education; D003198:Computer Simulation; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement / Q000379:methods; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007442:Intubation, Intratracheal / Q000379:methods*; D008397:Masks; D008505:Medical Staff, Hospital / Q000193:education*; D013022:South Carolina