RT Journal Article
SR Electronic
T1 Improving Students' Knowledge and Skills Through a Tele-ICU Clinical Rotation
JF Respiratory Care
FD American Association for Respiratory Care
SP 789
OP 794
DO 10.4187/respcare.09896
VO 67
IS 7
A1 Karsten J Roberts
A1 Karen K Zumstein
A1 Thomas R Lamphere
A1 Maria Williams
A1 Susan A Powell
A1 Alexa Moran
A1 Brian Kellar
A1 William R Solly
A1 Margarete Pierce
YR 2022
UL http://rc.rcjournal.com/content/67/7/789.abstract
AB BACKGROUND: In the course of their education, respiratory therapy students participate in clinical rotations, which are essential to their education. Recently, the number of clinical sites has decreased as some have been eliminated. During the COVID-19 pandemic, schools were challenged to find hospitals to accommodate students due to the risk of infection. Tele-ICU has emerged as a means for staff therapists to assess and monitor patients via remote monitoring systems. We hypothesized that a clinical rotation at a tele-ICU would strengthen students' knowledge of mechanical ventilation, telemedicine, and COVID-19.METHODS: In this study, students completed clinical rotations in a tele-ICU. Students spent two 4-h clinical rotations rounding on 320 ICU beds at 5 hospitals. Under the supervision of experienced therapists, students performed remote patient-ventilator assessments, including review and interpretation of ventilator waveforms, patient-ventilator interaction, arterial blood gases, and chest x-rays. Students completed pre- and post-rotation surveys assessing their confidence managing mechanical ventilation, experience with telemedicine, ARDS, and patients with COVID-19.RESULTS: Mean self-confidence in mechanical ventilation (P = .001), assessing waveforms (P = .001), and knowledge of ARDS increased after the clinical rotation (P = .001). Similarly, reported knowledge related to spontaneous breathing trial protocols (P = .009), lung-protective ventilation (P = .002), patient care planning (P = .001), and use of Excel spreadsheets (P = .002) increased from the beginning to the end of the clinical rotation. Student confidence in interprofessional communication increased from 85 [69–98] to 95 [78–100]; P = .03). Overall, the largest change was students' ability to assess patients with COVID-19 (pre-rotation 50.0 [11.5–65.7], post-rotation 80.0 [58.5–100]; P = .001). Qualitative results revealed overwhelmingly positive results for both students and preceptors.CONCLUSIONS: Students' confidence in assessing patients via remote monitoring increased in a tele-ICU clinical rotation. Self-assessed knowledge related to COVID-19 also increased to statistical significance.