Respiratory Care Post-Orientation Curriculum Simulations

Abstract

Background:

Respiratory therapists are an integral part of the critical care team as they are specialist in airway and ventilator management. Currently newly graduated respiratory therapists have limited exposure to advanced critical care technologies and critical training. Once the allotted orientation period is over, the expectation is for recent graduates to master equipment and procedures in a high stress environment. The post orientation period is when recent graduates would benefit from practicing skills and reviewing policies. The Respiratory Care Department at Boston Children’s Hospital adopted a high fidelity simulation for new RTs to become proficient with low volume high risk procedures, skills and knowledge. The SIMPeds center at Boston Children’s Hospital offers 2 simulation sites on campus and also an entire SIM center across the street from the hospital Methods: While the respiratory care department was involved with numerous multidisciplinary simulations throughout the hospital but they were not fulfilling the needs of the post orientation periods of our new therapists. We decided to offer a safe environment fostering communication skills as they practice these identified high risk skills. The course consists of didactic skills sessions; two simulations and debriefings, lasting in total five hours. Participants employed six months to a year and a resource therapist. To enhance the dynamic of the simulations, we have recruited an RN and MD to make the experience more realistic. The didactic concentrates on communication and other principals of crisis resource management. The simulation scenarios combine both the skill sets reviewed and didactic portion for a cohesive curriculum.

Results:

There were 57 RTs, (73% of the department) who completed this course. We have held 12 courses in the past 3.5 years. Participants are asked to complete a Likert scale survey at the end of the course, with IRB approval. Of the 57 responses: Conclusions: After reviewing the results from the Likert survey and the answers to some of the open ended questions, it was evident that not only was there a need for the course, but also a request for more simulations in the future. There were 12 requests for more simulations and among those requests were 8 for simulations twice a year for all staff members

Results

 	Strongly agree	Disagree	Neutral	Agree	Strongly Agree
The program will help me provide safer/more effective pt care	 	 	1 (2%)	9 (16%)	47 (82%)
I feel that I can now function more effectively in the ICU	 	 	 	12 (21%)	45 (79%)
Despite limitations, the SIMS were realistic	 	 	1 (2%)	13 (23%)	43 (75%)
During debriefings, I was treated with respect	 	 	 	4 (7%)	53 (93%)
The atmosphere was supportive	 	 	 	4 (7%)	53 (93%)
I was comfortable sharing my feelings/thoughts in debriefings	 	 	 	8 (14%)	49 (86%)
Debriefings clarified the clinical objectives of the scenarios	 	 	 	8 (14%)	49 (86%)