Online Learning and Residents' Acquisition of Mechanical Ventilation Knowledge: Sequencing Matters

Traci A. Wolbrink; Sandrijn M. Van Schaik; David A. Turner; Steven J. Staffa; Eleanor Keller; Donald L. Boyer; Grace Chong; Jarrod Cross; Sylvia Del Castillo; Andrew Feng; R. Stanley Hum; Ebor Jacob James; Amanda Johnson; Sarah Kandil; Martin Kneyber; Ramachandran Rameshkumar; Amanda Levin; Rakesh Lodha; Muralidharan Jayashree; Anthony Olivero; Felix Oberender; Rahul S. Panesar; Puneet A. Pooni; Kyle J. Rehder; Shuba Sankaranarayanan; Margaret Scheffler; Rana Sharara-Chami; Ashley L. Siems; Rajakumar Padur Sivaraman; Ken Tegtmeyer; Stacey Valentine; Florencia Villois; Amelie Von Saint Andre-Von Arnim; Margaret Winkler; Chris Dede; Jeffrey P. Burns

doi:10.1097/CCM.0000000000004071

Online Learning and Residents' Acquisition of Mechanical Ventilation Knowledge: Sequencing Matters

Traci A. Wolbrink, Sandrijn M. Van Schaik, David A. Turner, Steven J. Staffa, Eleanor Keller, Donald L. Boyer, Grace Chong, Jarrod Cross, Sylvia Del Castillo, Andrew Feng, R. Stanley Hum, Ebor Jacob James, Amanda Johnson, Sarah Kandil, Martin Kneyber, Ramachandran Rameshkumar, Amanda Levin, Rakesh Lodha, Muralidharan Jayashree, Anthony OliveroFelix Oberender, Rahul S. Panesar, Puneet A. Pooni, Kyle J. Rehder, Shuba Sankaranarayanan, Margaret Scheffler, Rana Sharara-Chami, Ashley L. Siems, Rajakumar Padur Sivaraman, Ken Tegtmeyer, Stacey Valentine, Florencia Villois, Amelie Von Saint Andre-Von Arnim, Margaret Winkler, Chris Dede, Jeffrey P. Burns

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Objective: Rapid advancements in medicine and changing standards in medical education require new, efficient educational strategies. We investigated whether an online intervention could increase residents' knowledge and improve knowledge retention in mechanical ventilation when compared with a clinical rotation and whether the timing of intervention had an impact on overall knowledge gains. Design: A prospective, interventional crossover study conducted from October 2015 to December 2017. Setting: Multicenter study conducted in 33 PICUs across eight countries. Subjects: Pediatric categorical residents rotating through the PICU for the first time. We allocated 483 residents into two arms based on rotation date to use an online intervention either before or after the clinical rotation. Interventions: Residents completed an online virtual mechanical ventilation simulator either before or after a 1-month clinical rotation with a 2-month period between interventions. Measurements and Main Results: Performance on case-based, multiple-choice question tests before and after each intervention was used to quantify knowledge gains and knowledge retention. Initial knowledge gains in residents who completed the online intervention (average knowledge gain, 6.9%; sd, 18.2) were noninferior compared with those who completed 1 month of a clinical rotation (average knowledge gain, 6.1%; sd, 18.9; difference, 0.8%; 95% CI, -5.05 to 6.47; p = 0.81). Knowledge retention was greater following completion of the online intervention when compared with the clinical rotation when controlling for time (difference, 7.6%; 95% CI, 0.7-14.5; p = 0.03). When the online intervention was sequenced before (average knowledge gain, 14.6%; sd, 15.4) rather than after (average knowledge gain, 7.0%; sd, 19.1) the clinical rotation, residents had superior overall knowledge acquisition (difference, 7.6%; 95% CI, 2.01-12.97;p = 0.008). Conclusions: Incorporating an interactive online educational intervention prior to a clinical rotation may offer a strategy to prime learners for the upcoming rotation, augmenting clinical learning in graduate medical education.

Original language	English (US)
Pages (from-to)	E1-E8
Journal	Critical care medicine
Volume	48
Issue number	1
DOIs	https://doi.org/10.1097/CCM.0000000000004071
State	Published - Jan 1 2020
Externally published	Yes

Keywords

flipped classroom
graduate medical education
mechanical ventilation
online learning
pediatric critical care medicine
virtual simulation

ASJC Scopus subject areas

Critical Care and Intensive Care Medicine

Access to Document

10.1097/CCM.0000000000004071

Cite this

Wolbrink, T. A., Van Schaik, S. M., Turner, D. A., Staffa, S. J., Keller, E., Boyer, D. L., Chong, G., Cross, J., Del Castillo, S., Feng, A., Hum, R. S., Jacob James, E., Johnson, A., Kandil, S., Kneyber, M., Rameshkumar, R., Levin, A., Lodha, R., Jayashree, M., ... Burns, J. P. (2020). Online Learning and Residents' Acquisition of Mechanical Ventilation Knowledge: Sequencing Matters. Critical care medicine, 48(1), E1-E8. https://doi.org/10.1097/CCM.0000000000004071

Wolbrink, TA, Van Schaik, SM, Turner, DA, Staffa, SJ, Keller, E, Boyer, DL, Chong, G, Cross, J, Del Castillo, S, Feng, A, Hum, RS, Jacob James, E, Johnson, A, Kandil, S, Kneyber, M, Rameshkumar, R, Levin, A, Lodha, R, Jayashree, M, Olivero, A, Oberender, F, Panesar, RS, Pooni, PA, Rehder, KJ, Sankaranarayanan, S, Scheffler, M, Sharara-Chami, R, Siems, AL, Padur Sivaraman, R, Tegtmeyer, K, Valentine, S, Villois, F, Von Saint Andre-Von Arnim, A, Winkler, M, Dede, C & Burns, JP 2020, 'Online Learning and Residents' Acquisition of Mechanical Ventilation Knowledge: Sequencing Matters', Critical care medicine, vol. 48, no. 1, pp. E1-E8. https://doi.org/10.1097/CCM.0000000000004071

@article{6cf7a58225094d4fa456da051b6d8407,

title = "Online Learning and Residents' Acquisition of Mechanical Ventilation Knowledge: Sequencing Matters",

abstract = "Objective: Rapid advancements in medicine and changing standards in medical education require new, efficient educational strategies. We investigated whether an online intervention could increase residents' knowledge and improve knowledge retention in mechanical ventilation when compared with a clinical rotation and whether the timing of intervention had an impact on overall knowledge gains. Design: A prospective, interventional crossover study conducted from October 2015 to December 2017. Setting: Multicenter study conducted in 33 PICUs across eight countries. Subjects: Pediatric categorical residents rotating through the PICU for the first time. We allocated 483 residents into two arms based on rotation date to use an online intervention either before or after the clinical rotation. Interventions: Residents completed an online virtual mechanical ventilation simulator either before or after a 1-month clinical rotation with a 2-month period between interventions. Measurements and Main Results: Performance on case-based, multiple-choice question tests before and after each intervention was used to quantify knowledge gains and knowledge retention. Initial knowledge gains in residents who completed the online intervention (average knowledge gain, 6.9%; sd, 18.2) were noninferior compared with those who completed 1 month of a clinical rotation (average knowledge gain, 6.1%; sd, 18.9; difference, 0.8%; 95% CI, -5.05 to 6.47; p = 0.81). Knowledge retention was greater following completion of the online intervention when compared with the clinical rotation when controlling for time (difference, 7.6%; 95% CI, 0.7-14.5; p = 0.03). When the online intervention was sequenced before (average knowledge gain, 14.6%; sd, 15.4) rather than after (average knowledge gain, 7.0%; sd, 19.1) the clinical rotation, residents had superior overall knowledge acquisition (difference, 7.6%; 95% CI, 2.01-12.97;p = 0.008). Conclusions: Incorporating an interactive online educational intervention prior to a clinical rotation may offer a strategy to prime learners for the upcoming rotation, augmenting clinical learning in graduate medical education.",

keywords = "flipped classroom, graduate medical education, mechanical ventilation, online learning, pediatric critical care medicine, virtual simulation",

author = "Wolbrink, {Traci A.} and {Van Schaik}, {Sandrijn M.} and Turner, {David A.} and Staffa, {Steven J.} and Eleanor Keller and Boyer, {Donald L.} and Grace Chong and Jarrod Cross and {Del Castillo}, Sylvia and Andrew Feng and Hum, {R. Stanley} and {Jacob James}, Ebor and Amanda Johnson and Sarah Kandil and Martin Kneyber and Ramachandran Rameshkumar and Amanda Levin and Rakesh Lodha and Muralidharan Jayashree and Anthony Olivero and Felix Oberender and Panesar, {Rahul S.} and Pooni, {Puneet A.} and Rehder, {Kyle J.} and Shuba Sankaranarayanan and Margaret Scheffler and Rana Sharara-Chami and Siems, {Ashley L.} and {Padur Sivaraman}, Rajakumar and Ken Tegtmeyer and Stacey Valentine and Florencia Villois and {Von Saint Andre-Von Arnim}, Amelie and Margaret Winkler and Chris Dede and Burns, {Jeffrey P.}",

note = "Funding Information: Supported, in part, by the Department of Anesthesiology, Critical Care and Pain Management at Boston Children{\textquoteright}s Hospital. Funding Information: Dr. Boyer received funding from University of Pennsylvania Graduate School of Education (MedEd Master{\textquoteright}s Program leadership and teaching). The remaining authors have disclosed that they do not have any potential conflicts of interest. Publisher Copyright: {\textcopyright} 2020 Lippincott Williams and Wilkins. All rights reserved.",

year = "2020",

month = jan,

day = "1",

doi = "10.1097/CCM.0000000000004071",

language = "English (US)",

volume = "48",

pages = "E1--E8",

journal = "Critical care medicine",

issn = "0090-3493",

publisher = "Lippincott Williams and Wilkins",

number = "1",

}

TY - JOUR

T1 - Online Learning and Residents' Acquisition of Mechanical Ventilation Knowledge

T2 - Sequencing Matters

AU - Wolbrink, Traci A.

AU - Van Schaik, Sandrijn M.

AU - Turner, David A.

AU - Staffa, Steven J.

AU - Keller, Eleanor

AU - Boyer, Donald L.

AU - Chong, Grace

AU - Cross, Jarrod

AU - Del Castillo, Sylvia

AU - Feng, Andrew

AU - Hum, R. Stanley

AU - Jacob James, Ebor

AU - Johnson, Amanda

AU - Kandil, Sarah

AU - Kneyber, Martin

AU - Rameshkumar, Ramachandran

AU - Levin, Amanda

AU - Lodha, Rakesh

AU - Jayashree, Muralidharan

AU - Olivero, Anthony

AU - Oberender, Felix

AU - Panesar, Rahul S.

AU - Pooni, Puneet A.

AU - Rehder, Kyle J.

AU - Sankaranarayanan, Shuba

AU - Scheffler, Margaret

AU - Sharara-Chami, Rana

AU - Siems, Ashley L.

AU - Padur Sivaraman, Rajakumar

AU - Tegtmeyer, Ken

AU - Valentine, Stacey

AU - Villois, Florencia

AU - Von Saint Andre-Von Arnim, Amelie

AU - Winkler, Margaret

AU - Dede, Chris

AU - Burns, Jeffrey P.

N1 - Funding Information: Supported, in part, by the Department of Anesthesiology, Critical Care and Pain Management at Boston Children’s Hospital. Funding Information: Dr. Boyer received funding from University of Pennsylvania Graduate School of Education (MedEd Master’s Program leadership and teaching). The remaining authors have disclosed that they do not have any potential conflicts of interest. Publisher Copyright: © 2020 Lippincott Williams and Wilkins. All rights reserved.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Objective: Rapid advancements in medicine and changing standards in medical education require new, efficient educational strategies. We investigated whether an online intervention could increase residents' knowledge and improve knowledge retention in mechanical ventilation when compared with a clinical rotation and whether the timing of intervention had an impact on overall knowledge gains. Design: A prospective, interventional crossover study conducted from October 2015 to December 2017. Setting: Multicenter study conducted in 33 PICUs across eight countries. Subjects: Pediatric categorical residents rotating through the PICU for the first time. We allocated 483 residents into two arms based on rotation date to use an online intervention either before or after the clinical rotation. Interventions: Residents completed an online virtual mechanical ventilation simulator either before or after a 1-month clinical rotation with a 2-month period between interventions. Measurements and Main Results: Performance on case-based, multiple-choice question tests before and after each intervention was used to quantify knowledge gains and knowledge retention. Initial knowledge gains in residents who completed the online intervention (average knowledge gain, 6.9%; sd, 18.2) were noninferior compared with those who completed 1 month of a clinical rotation (average knowledge gain, 6.1%; sd, 18.9; difference, 0.8%; 95% CI, -5.05 to 6.47; p = 0.81). Knowledge retention was greater following completion of the online intervention when compared with the clinical rotation when controlling for time (difference, 7.6%; 95% CI, 0.7-14.5; p = 0.03). When the online intervention was sequenced before (average knowledge gain, 14.6%; sd, 15.4) rather than after (average knowledge gain, 7.0%; sd, 19.1) the clinical rotation, residents had superior overall knowledge acquisition (difference, 7.6%; 95% CI, 2.01-12.97;p = 0.008). Conclusions: Incorporating an interactive online educational intervention prior to a clinical rotation may offer a strategy to prime learners for the upcoming rotation, augmenting clinical learning in graduate medical education.

AB - Objective: Rapid advancements in medicine and changing standards in medical education require new, efficient educational strategies. We investigated whether an online intervention could increase residents' knowledge and improve knowledge retention in mechanical ventilation when compared with a clinical rotation and whether the timing of intervention had an impact on overall knowledge gains. Design: A prospective, interventional crossover study conducted from October 2015 to December 2017. Setting: Multicenter study conducted in 33 PICUs across eight countries. Subjects: Pediatric categorical residents rotating through the PICU for the first time. We allocated 483 residents into two arms based on rotation date to use an online intervention either before or after the clinical rotation. Interventions: Residents completed an online virtual mechanical ventilation simulator either before or after a 1-month clinical rotation with a 2-month period between interventions. Measurements and Main Results: Performance on case-based, multiple-choice question tests before and after each intervention was used to quantify knowledge gains and knowledge retention. Initial knowledge gains in residents who completed the online intervention (average knowledge gain, 6.9%; sd, 18.2) were noninferior compared with those who completed 1 month of a clinical rotation (average knowledge gain, 6.1%; sd, 18.9; difference, 0.8%; 95% CI, -5.05 to 6.47; p = 0.81). Knowledge retention was greater following completion of the online intervention when compared with the clinical rotation when controlling for time (difference, 7.6%; 95% CI, 0.7-14.5; p = 0.03). When the online intervention was sequenced before (average knowledge gain, 14.6%; sd, 15.4) rather than after (average knowledge gain, 7.0%; sd, 19.1) the clinical rotation, residents had superior overall knowledge acquisition (difference, 7.6%; 95% CI, 2.01-12.97;p = 0.008). Conclusions: Incorporating an interactive online educational intervention prior to a clinical rotation may offer a strategy to prime learners for the upcoming rotation, augmenting clinical learning in graduate medical education.

KW - flipped classroom

KW - graduate medical education

KW - mechanical ventilation

KW - online learning

KW - pediatric critical care medicine

KW - virtual simulation

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ER -

Online Learning and Residents' Acquisition of Mechanical Ventilation Knowledge: Sequencing Matters

Abstract

Keywords

ASJC Scopus subject areas

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