Simulation has several potential applications in medical training and professional development in India.^[1] It has long been integrated in anesthesiology training in modern day teaching curriculum. It has been used as a supplemental tool for training in high stake situations and life threatening events with the benefit of reducing patient safety concerns and permitting repetitive practice thus minimizing the margin of error. Rare conditions can be initiated to give trainees practice in patient management before encountering these challenges in clinical context ^[2].

One of the recent outbreaks that have gained global concern with rampant spread is COVID 19 pandemic. It has brought unprecedented challenges as the disease overwhelms health care systems and stresses the clinical workforce.

Majority of patients affected with COVID 19 require ICU admissions and few of them may also require mechanical ventilation ^[3], which has a very important role in the management of this pandemic.

Ventilator management requires highly trained professionals typically, intensive care physicians, anesthesiologists, respiratory therapists. But, because of risk involved in disease spread causing health care workers to become sick or worse, increase in mortality rate, the need of more number of experienced manpower to handle ventilator with knowledge on ventilators graphics becomes very much essential.

Due to the risk involved by patient exposure and to preserve protective equipment (PPEs), bed side teaching becomes more difficult

In order to supplement this shortage we have come up with an alternative for teaching ventilatory management in non anesthesiology residents.

Medical, nursing and other healthcare staff also have an opportunity to develop and refine their skills repeatedly, if necessary, using simulation technology without putting patients at risk.^[4]

In medical education, there should be exposure to live patients so that medical students and doctors can acquire the necessary skills. There is also, on the other hand, an obligation to provide optimal treatment and to ensure patients’ safety and well-being. These two competing needs can sometimes pose a dilemma in medical education.^[5]

We designed this study to meet the global requirement of knowledge on ventilatory management and due to paucity of literature in COVID patients.

Objectives:

1.     To prepare a module for non anesthesiology trainees to handle ventilators in management of COVID 19 patients.

2.     To evaluate the effectiveness of the testing module by conducting pre & post test and feedback.

METHODOLOGY:

A quasi experimental study will be conducted among 50 trainees who don’t have any prior exposure to handle ventilators. The study participants will be selected by non probability sampling and consent will be obtained from them after explaining the study. Institutional Ethical Committee clearance will be obtained from institutional ethical board GSL Medical College.

A teaching module will be prepared and validated which will consist Lectures on simulation guided ventilator graphics, audio-video sessions, demonstration as well as hands on training. A team of trained anesthetists will train the trainees on knowledge as well as skill based teaching with the help of the teaching module and HPS simulator. Total 2 sessions will be conducted with 25 trainees in each.

The human patient (HPS) simulator is a human sized high fidelity mannequin with features such as palpable pulses, chest wall expansion, audible breath sounds, and facility for intubation; scenarios can be created and respond to anaesthetics and COVID pneumonia like picture can be modeled.

A debriefing session will be carried out after every scenario, which will start with the trainee describing what happened during the scenario. This will be followed by analytical phase in which the trainee will be asked the successful aspects of the scenario and the factors that could have been improved. In the last phase of debriefing session, participants will be asked to reflect upon their training.

A pre & post evaluation (Total 20 questions each carries 1 mark) will be conducted to assess the effectiveness of the in teaching module. The scores will be compared by wilcoxon sign rank test.

Skill based assessment will be conducted by OSCE method.

Feedback will be taken from the participants in a five point likert’s scale at the end of the teaching learning session.