Qualitative Survey of Second-Year Respiratory Therapy Students' Experience in a Tele-ICU Clinical Rotation

Abstract

Background: During the COVID-19 pandemic, we initiated a new clinical rotation for respiratory care students in a virtual ICU (eICU). During this rotation, students experienced an increase in their baseline knowledge of telemedicine and mechanical ventilation. We hypothesized that qualitative feedback of the clinical rotations would reflect a positive learning experience.

Methods: Students from two universities completed clinical rotations in a tele-ICU as a part of an IRB-approved observational study. They completed two, four-hour rotations with a telemedicine RT preceptor (eRT) with experience in the eICU. Students were involved in remote patient assessment, review and interpretation of ventilator waveforms, blood gases, and chest x-rays. Students received an introduction to lung protective ventilation, spontaneous breathing, and broncho-pulmonary hygiene protocols. At the end of the second day of the clinical rotation, students completed a survey which included qualitative questions regarding their experience.

Results: In their comments, students stated eRTs provided guidance and created a comfortable learning environment that students would recommend to others. Interaction with tele-ICU RNs (eRN) was described as friendly, knowledgeable, and helpful. Students noted the high level of teamwork in the eICU and that they observed quality patient care provided. Students stated that interactions with tele-ICU MDs were educational; however, forty percent of students reported not interacting with eMDs. While some of the students did not interact with staff in the physical ICU, others noted that interactions via telecommunication platforms were positive and friendly. The biggest difference noted between this rotation and in-person rotations was that it is not hands on; however, students stated they were able to focus on technology and learning about ventilator waveforms and mechanics. When asked what it takes to be an effective eRT, a willingness to learn and be involved was described. Students felt it was important to be knowledgeable about technology, modes of mechanical ventilation, and waveforms. Additionally, the students noted it was important to be knowledgeable about diseases and patient-ventilator synchrony.

Conclusions: Students’ experience in a virtual ICU was overwhelmingly positive, providing new perspectives on patient care.