title: Academic Emergency Medicine Physicians' Knowledge of Mechanical Ventilation.
abstract: BACKGROUND
  Although emergency physicians frequently intubate patients, management of mechanical ventilation has not been emphasized in emergency medicine (EM) education or clinical practice. The objective of this study was to quantify EM attendings' education, experience, and knowledge regarding mechanical ventilation in the emergency department.
  
  
  METHODS
  We developed a survey of academic EM attendings' educational experiences with ventilators and a knowledge assessment tool with nine clinical questions. EM attendings at key teaching hospitals for seven EM residency training programs in the northeastern United States were invited to participate in this survey study. We performed correlation and regression analyses to evaluate the relationship between attendings' scores on the assessment instrument and their training, education, and comfort with ventilation.
  
  
  RESULTS
  Of 394 EM attendings surveyed, 211 responded (53.6%). Of respondents, 74.5% reported receiving three or fewer hours of ventilation-related education from EM sources over the past year and 98 (46%) reported receiving between 0-1 hour of education. The overall correct response rate for the assessment tool was 73.4%, with a standard deviation of 19.9. The factors associated with a higher score were completion of an EM residency, prior emphasis on mechanical ventilation during one's own residency, working in a setting where an emergency physician bears primary responsibility for ventilator management, and level of comfort with managing ventilated patients. Physicians' comfort was associated with the frequency of ventilator changes and EM management of ventilation, as well as hours of education.
  
  
  CONCLUSIONS
  EM attendings report caring for mechanically ventilated patients frequently, but most receive fewer than three educational hours a year on mechanical ventilation, and nearly half receive 0-1 hour. Physicians' performance on an assessment tool for mechanical ventilation is most strongly correlated with their self-reported comfort with mechanical ventilation.
authors.affiliation: Medical University of South Carolina, Divisions of Emergency Medicine and Pulmonary, Critical Care and Sleep Medicine, Charleston, South Carolina.
authors.forename: Susan R
authors.initials: SR
authors.lastname: Wilcox
authors.affiliation: Maine Medical Center, Department of Emergency Medicine, Portland, Maine.
authors.forename: Tania D
authors.initials: TD
authors.lastname: Strout
authors.affiliation: Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts.
authors.forename: Jeffrey I
authors.initials: JI
authors.lastname: Schneider
authors.affiliation: Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Mitchell
authors.affiliation: Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island.
authors.forename: Jessica
authors.initials: J
authors.lastname: Smith
authors.affiliation: Baystate Medical Center, Department of Emergency Medicine, Springfield, Massachusetts.
authors.forename: Lucienne
authors.initials: L
authors.lastname: Lutfy-Clayton
authors.affiliation: Yale University School of Medicine, Departments of Emergency Medicine and Neurology, Divisions of Neurocritical Care and Emergency Neurology and Surgical Critical Care, New Haven, Connecticut.
authors.forename: Evie G
authors.initials: EG
authors.lastname: Marcolini
authors.affiliation: Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut.
authors.forename: Ani
authors.initials: A
authors.lastname: Aydin
authors.affiliation: Department of Emergency Medicine and Critical Care, Kaiser Permanente East Bay, Oakland and Richmond Medical Centers, California.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Seigel
authors.affiliation: Medical University of South Carolina, Division of Pulmonary, Critical Care and Sleep Medicine, Charleston, South Carolina.
authors.forename: Jeremy B
authors.initials: JB
authors.lastname: Richards
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education* / Q000592:standards; D019983:Guideline Adherence; D006801:Humans; D007396:Internship and Residency; D010820:Physicians; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012121:Respiration, Artificial; D014481:United States / Q000453:epidemiology