Teaching and Assessing Bag Valve Mask Ventilation to 4th Year Medical Students via Checklist
Abstract
Learning Objectives: Create a checklist that is expert reviewed to teach BVM to 4th year medical students. Implement a curriculum to teach using the checklist and then assess performance with high-fidelity simulation.
Introduction: Bag-valve-mask ventilation (BMV) is an essential skill to master when teaching medical students basic airway management. Standardized checklists help teach and assess learners. A validated checklist for teaching BMV to medical students does not exist in the literature. Current standards typically involve teaching learners BMV skills on mannequins in static situations.
Educational Objective: Create a checklist that is expert reviewed to teach BVM to 4th year medical students. Implement a curriculum to teach using the checklist and then assess performance with high-fidelity simulation.
Curricular Design: A previously published checklist was improved upon using expert consensus of 10 EM and 10 anesthesia faculty. A 2-handed technique using an oropharyngeal airway was emphasized to maximize a novice’s success. Senior anesthesiology and EM residents taught 200 4th year medical students using rapid sequence deliberate practice methods and the checklist. After achieving proficiency, they participated in a SIM case that required BMV. Video review was used to assess the students’ skills with the checklist.
Impact/Effectiveness: We now have a standardized, expert reviewed checklist to teach BMV skills to 4th year medical students. While all students achieved proficiency using a static mannequin, many of the students’ skills deteriorated in the high-fidelity simulation. For example, in the simulation, only 65% of students connected the oxygen to the wall correctly, 24% of students did not use the two-handed technique, and 81% of students did not correctly size and insert the oropharyngeal airway. Since our goal is to teach students BVM for use in the hospital environment, by collecting the high-fidelity simulation data we know that our method was inadequate for skill retention in the complex environment. This enables us to continue curriculum development this year incorporating more repetition in a complex environment.