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Study Objectives: By the end of this activity, residents will 1) Understand indications for appropriate bilevel positive airway pressure (BiPAP) use and will be able to identify when contraindications exist 2) Demonstrate understanding of appropriate BiPAP settings and realize when adjustments are necessary 3) Set up BiPAP machine for use without assistance which includes equipment set up, understanding function of machine interface and physical application to patient 4) Demonstrate ability to adjust BiPAP settings to specific respiratory pathologies through successful completion of table simulation scenarios Methods: This curriculum was designed during the COVID-19 pandemic and therefore administered virtually through use of the Zoom video conference platform Due to the virtual nature, this presentation was created using PowerPoint that was then shared for all learners to view in real-time This presentation requires approximately 1 hour to deliver the entirety of the material This lecture was originally administered on April 29, 2020 during Thomas Jefferson Hospital’s Emergency Medicine residency weekly conference The lecture relies on audience participation for the majority of the slides and involves case presentations with tabletop simulations The evaluation strategy was structured to measure Kirkpatrick level 2a outcomes by assessing the learners’ modification of attitude and perception regarding personal BiPAP skill level Learners received a 3-question, Likert-style survey prior to the start of this course and then immediately following the course’s completion Results: There were 35 emergency medicine residents who experienced the implementation of this lecture Of this number, 33 residents completed the pre-survey and 28 residents completed the post-survey The surveys were conducted anonymously with an open-ended portion in the post-survey to allow for specific feedback Prior to this session, 33% of residents disagreed with the statement, “I am confident that I could independently set up a BiPAP machine for a patient who is in acute respiratory distress ” and following the session, this shifted to 100% of residents agreeing with the statement Resident responses to the statement, “I am confident that I would know how to adjust the IPAP and/or EPAP setting if a patient did not improve after the initial settings” shifted from 52% disagreeing to 100% agreeing following completion of this course Conclusion: Overall, this curriculum promoted improved confidence with residents and how they perceive their abilities when it comes to managing BiPAP Prior to this course, there was variation with whether residents agreed or disagreed regarding their confidence pertaining to BiPAP However, the post-survey demonstrated a total shift to the “agree” statements This course originally was designed to occur in-person and included hands-on practice with actual BiPAP machines loaned from the emergency department Due to the nature of the pandemic, this portion was removed;however, once quarantine restrictions are lifted, it would likely be beneficial to incorporate this back into the presentation Other considerations to broaden this curriculum set would be to also include education with pediatric BiPAP as well as an overview of how to troubleshoot various alarms Due to time restrictions, there was not time to include these components but would be an interesting addition for the future
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