Improving internal medicine resident proficiency in non-invasive positive pressure ventilation and oxygen modalities...

Simulation-based training is increasingly used to teach respiratory interventions, but limited studies have evaluated its impact on both non-invasive positive pressure ventilation (NIPPV) and supplemental oxygen delivery systems. We assessed changes in internal medicine residents' knowledge and attitudes before and after a simulation-based training program.

This is a retrospective study of a simulation-based training program. There were 78 internal medicine residents from postgraduate first year (PGY1), postgraduate second year (PGY2), and postgraduate third year (PGY3) who participated in a one-hour training session, including lecture and three simulation stations covering oxygen delivery devices, high-flow nasal cannula, and bi-level positive airway pressure/continuous positive airway pressure (BIPAP/CPAP). Pre- and post-training questionnaires assessed attitudes and knowledge.

Attitudes for comfort level or recognition increased after training (all p < 0.001), and attitudes for needing more training decreased after training (all p < 0.001). Specific knowledge increased after training with percentage-point differences ranging from 48.7% to 60.3% for all of the questions (all p < 0.001). Case scenario knowledge increased after training with percentage-point differences ranging from 29.4% to 48.7% (all p < 0.001). Knowledge differences between postgraduate years were mostly eliminated after training. All residents rated the training highly.

Simulation-based training improved attitudes and knowledge for both oxygen modalities and NIPPV. PGY1 and PGY2 residents achieved knowledge levels similar to PGY3 residents after the training. We recommend incorporating simulation-based respiratory training into residency programs to improve resident competency for both oxygen modalities and NIPPV.