F lo w , lite rs/m in u te

VOLUME CYCLED VENTILATION 1

Is guidance desired? y or n y
Set tidal volume, ml 500
Set frequency 20
Inspired oxygen, % 21 100
Set PEEP 10 80
Set peak inspiratory flow, lpm 60 60
Inspiratory pause duration, seconds 0.00 40
20

This is patient number 1 0

0 2 4
-20
Attempt number on this patient 0
-40
-60
Observed tidal volume, ml 500
-80
Observed minute ventilation, liters 10.0 -100

OUTCOMES Observed Goal min Goal Max

O2 saturation 96 90 --
pH 7.45 7.35 7.45
Mean arterial pressure 52 65 --
Plateau pressure 18 -- 30
Push to run with selected mode and settings P

Push to administer fluid bolus

Push to run per
Push to change ventilator mode
 Airway flow

2 4 6 8 10 12 14

Time, seconds

Oxygenation is acceptable
pH too high. Consider decreasing frequency or tidal volume
MAP too low. Consider decreasing frequency, tidal volume, or PEEP OR giving
Plateau pressure is acceptable
Push when treatment goals have been attained
Push to abandon current patient and move on
Push to run performance assessment; you must have completed at least 10 cases

Push to completely clear simulator and start over

!THIS WILL ERASE ALL PREVIOUS WORK !
 14

PEEP OR giving fluid bolus

10 cases
 % o f v e n ti l a t o r c h a n g e s p r o v o k i n g o r w o r s e n i n g d e r a n g e mP e rn ct e n t o f f a ile d c a s e s in c la s s
Attempt numbers
Overall Average number of attempts needed to solve cases
Recruitable
Asthma
12
COPD
10
Restrictive Failure rate
Unrecruitable Hypoxia Hypo
8
12
% o f v e n ti l a t o r c h a n g e s c o m p l i c a t e d b y d e r a n g e m e n t

Failure
6 rates 10

Overall 8
4
Recruitable 6

Asthma
2 4

COPD 2
0
Restrictive 0
Overall Recruitable Asthma COPD Restrictive Unrecruitable Overall Re
Unrecruitable

Complication rates
Overall
Recruitable
Asthma
COPD
Restrictive
Unrecruitable Frequency of derangements during management of scenarios
Frequency with
Hypoxia Hypotension Overdistention Acidosis Alkalosis derangement
Hypoxia Hypo
12
Exacerbation
10
rates 12
10
Overall 8 8

Recruitable64 6
4
Asthma 2 2
0 0
COPD Overall Recruitable Asthma COPD Restrictive Unrecruitable Overall Rec

Restrictive
Unrecruitable
% o f v e n ti l a t o r c h a n g e s p r o v o k i n g o r w o r s e n i n g d e r a n g e mP e rn ct e n t o f f a ile d c a s e s in c la s s

Failure rates (failure to resolve derangement)

Hypoxia Hypotension Overdistention Acidosis Alkalosis
12

10

0
Overall Recruitable Asthma COPD Restrictive Unrecruitable

Frequency with which management provokes or worsens a given

derangement
Hypoxia Hypotension Overdistention Acidosis Alkalosis

12
10
8

6
4

2
0
Overall Recruitable Asthma COPD Restrictive Unrecruitable
 1

10

11

12
13

14

15

16

17

18

19

20
21

22

23
 Have you obtained

If you have not obtained your h

If you have not obtained your profe

How many yea

Have you completed fellowship or other advanced training in which the practice of mechanical v

Are you board c

In the past year, how many days have

How many days has it been- approximately- sinc

On an average day during which you care for patients undergoing mechanical ventilation, approxim
 On average, how man

Approximately how ofte

Approximately how often do you use pressure control ventilation, Bilevel ventilation, or APRV in patien

Were the cases simila

I gained knowledge about the press

I gained knowledge about the

Completion of the simulations m

 I believe that educational simulations might be a

I believe that simulation technology might be a valuable tool for assessing skills

Besides the user interface, what are the two most important aspects of the simulation software th