title: Emergency medicine residents' knowledge of mechanical ventilation.
abstract: BACKGROUND
  Although Emergency physicians frequently intubate patients, management of mechanical ventilation has not been emphasized in emergency medicine (EM) residency curricula.
  
  
  OBJECTIVE
  The objective of this study was to quantify EM residents' education, experience, and knowledge regarding mechanical ventilation.
  
  
  METHODS
  We developed a survey of residents' educational experiences with ventilators and an assessment tool with nine clinical questions. Correlation and regression analyses were performed to evaluate the relationship between residents' scores on the assessment instrument and their training, education, and comfort with ventilation.
  
  
  RESULTS
  Of 312 EM residents, 218 responded (69.9%). The overall correct response rate for the assessment tool was 73.3%, standard deviation (SD) ± 22.3. Seventy-seven percent (n = 167) of respondents reported ≤ 3 h of mechanical ventilation education in their residency curricula over the past year. Residents reported frequently caring for ventilated patients in the ED, as 64% (n = 139) recalled caring for ≥ 4 ventilated patients per month. Fifty-three percent (n = 116) of residents endorsed feeling comfortable caring for mechanically ventilated ED patients. In multiregression analysis, the only significant predictor of total test score was residents' comfort with caring for mechanically ventilated patients (F = 10.963, p = 0.001).
  
  
  CONCLUSIONS
  EM residents report caring for mechanically ventilated patients frequently, but receive little education on mechanical ventilation. Furthermore, as residents' performance on the assessment tool is only correlated with their self-reported comfort with caring for ventilated patients, these results demonstrate an opportunity for increased educational focus on mechanical ventilation management in EM residency training.
authors.affiliation: Department of Emergency Medicine, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Susan R
authors.initials: SR
authors.lastname: Wilcox
authors.affiliation: Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island; University of California San Francisco, San Francisco, California.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Seigel
authors.affiliation: Department of Emergency Medicine, Maine Medical Center, Portland, Maine.
authors.forename: Tania D
authors.initials: TD
authors.lastname: Strout
authors.affiliation: Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts.
authors.forename: Jeffrey I
authors.initials: JI
authors.lastname: Schneider
authors.affiliation: Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Mitchell
authors.affiliation: Department of Emergency Medicine, Yale-New Haven Hospital, New Haven, Connecticut.
authors.forename: Evie G
authors.initials: EG
authors.lastname: Marcolini
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Anesthesia Critical Care, Division of Critical Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Cocchi
authors.affiliation: Department of Emergency Medicine, Baystate Medical Center, Springfield, Massachusetts.
authors.forename: Howard A
authors.initials: HA
authors.lastname: Smithline
authors.affiliation: Department of Emergency Medicine, Baystate Medical Center, Springfield, Massachusetts.
authors.forename: Lucienne
authors.initials: L
authors.lastname: Lutfy-Clayton
authors.affiliation: Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Marie
authors.initials: M
authors.lastname: Mullen
authors.affiliation: Division of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Ilgen
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Jeremy B
authors.initials: JB
authors.lastname: Richards
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency; D008297:Male; D012044:Regression Analysis; D012121:Respiration, Artificial; D020377:Self Efficacy
keywords: critical care; education; mechanical ventilation; residents