Massive Hemoptysis Simulation Curriculum Improves Performance.

Area of Science:

• Medical Education
• Pulmonary Medicine
• Simulation-Based Training

Background:

• Massive hemoptysis is a rare, high-acuity medical emergency requiring integrated cognitive and procedural skills.
• Simulation is recommended for preparing healthcare professionals for high-acuity, low-occurrence procedures.
• The impact of simulation curricula on massive hemoptysis management has not been previously studied.

Purpose of the Study:

• To determine if a simulation curriculum improves competence in managing massive hemoptysis.
• To assess the effectiveness of simulation-based training for pulmonary and critical care medicine fellows.

Main Methods:

• A simulation curriculum for massive hemoptysis management was developed using Kern's six-step model.
• Pulmonary fellows participated in needs assessment and a manikin-based simulation using repetitive practice, clinical variation, and feedback.
• Performance was evaluated by time to management and competence using a combined metric of management priorities and global entrustment.

Main Results:

• Fellows reported low confidence in managing massive hemoptysis prior to simulation.
• Significant improvements were observed in time to successful management (14.24 to 10.26 min) and entrustment scores (4.11 to 4.61).
• Post-simulation, fellows reported enhanced self-assessed knowledge and confidence in hemoptysis management and endobronchial blocker placement.

Conclusions:

• Simulation-based training effectively improves pulmonary fellows' confidence and skills in managing massive hemoptysis.
• This curriculum enhances preparedness for high-acuity, low-occurrence clinical scenarios.
• Simulation is a valuable tool for medical education in critical care settings.