How Simulation-based Training Can Help Clinicians Develop the Skills to Use a Ventilator

As the COVID-19 pandemic reached the United States, governors across the country feared their state would not have enough ventilators to treat severely ill patients. Now, many of the hospitals hardest hit by the virus are experiencing a shortage of the staff needed to run those ventilators. To fill those vacancies, many hospitals are using simulation-based training to help clinicians who do not normally work with ventilators learn how to become familiar with the machines.

The need for ventilator management training

Patients with severe COVID-19 symptoms will often need to be put on a ventilator to help them breathe. When a patient is mechanically ventilated, a respiratory therapist and an internist (a doctor who has specific training in critical-care medicine) will provide care for them. However, as the number of COVID-19 patients surged, many hospitals did not have enough staff trained to manage ventilators.

To provide relief to healthcare workers (HCWs) already overworked before the COVID-19 pandemic, many hospitals have shifted staff over to their emergency and critical care departments. While many clinicians can intubate and subsequently mechanically ventilate the patient, the in-depth work of managing the ventilator requires specific training and skills.

Healthcare workers (HCWs) who do not specialize in critical care medicine or anesthesiology have little experience taking care of ventilated patients since residency programs do not emphasize ventilator management skills[1]. This means that many HCWs lack the clinical experience needed to take care of ventilated patients.

Developing ventilator skills through simulation

To ensure HCW have the skills to work with ventilators, many universities and hospitals are turning to simulation to train their clinicians and staff. Simulation allows clinicians to practice using a ventilator during a realistic scenario, developing their knowledge and skills before applying them to real people.

As the participants apply their skills and decision-making in a safe clinical environment, they receive feedback from educators. This allows the participants to identify mistakes, learn what went wrong, and improve their performance without putting real patients at risk. As the participants gain experience using the ventilators, they hone the skills needed to ensure better outcomes for their patients. 

Furthermore, a January 2020 study by the Society of Critical Care Medicine found that residents who completed five hours of simulated ventilation training had the same level of knowledge as those who completed month-long rotations in an ICU[2]. Thus, simulation-based training can be a useful tool for teaching ventilator management skills.

Simulation sessions can help clinicians learn new skills

As such, the South African Society of Anaesthesiologists (SASA) is using Gaumard’s HAL 3201 patient simulator to help train anesthesiologists on induction and intubation protocols. SASA developed a COVID-19 airway management checklist that aims to prevent the spread of infection during emergency scenarios. Participants use real tools and practice hands-on how to use a BVM, intubate, or mechanically ventilate a patient when they are suffering from critical conditions like ARDS or COPD.

As they develop these essential skills, participants also incorporate the SASA’s COVID-19 protocols. By practicing these new protocols on a simulator, participants integrate them into their routine until they become second nature. As a result, crucial moments for proper infection prevention are not missed during patient care, especially during airway emergencies.

Furthermore, since HAL 3201 can be placed on a real ventilator, participants can also learn how to modify the parameters of respiratory mechanics, including resistance, compliance, respiratory rate, etc. based on the best course of treatment.

Similarly, Lincoln Healthcare in Philadelphia developed a ventilator training program using Pediatric HAL to help train their at-home nurses on how to operate ventilators. The participants can work hands-on and practice establishing an airway and placing the patient on a ventilator. Since HAL can speak, the scenario also allows them to practice communication skills and develop the ability to reassure and calm pediatric patients during invasive procedures like ventilation.    

According to Autumn Lincoln, vice president and co-founder of Lincoln Healthcare, “We really wanted to make sure our nurses were armored with the best training, the best emergency preparedness [so they can handle any emergency] that could arise in the home.”

Simulation-based training is especially important now considering the need for HCWs during this public health crisis. As hospitals transition HCWs to their emergency and critical care departments, simulation-based training is helping to ensure their capacity to provide care can be enhanced, even during the pandemic. To learn more about HAL 3201, Pediatric HAL, or any of our patient simulators, please click on the link.

[1] Herpich, Nate. “Innovating to train medical pros on using mechanical ventilators.” The Harvard Gazette, Accessed 15 June 2020.

[2] Wolbrink, Traci A, et al. ” Online Learning and Residents’ Acquisition of Mechanical Ventilation Knowledge: Sequencing Matters.” Critical Care Medicine, vol. 48, no. 1, 2020, pp. 1-8.

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