SESSION TITLE: Non-Ventilatory Respiratory Support
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Monday, October 27, 2014 at 04:30 PM - 05:30 PM
PURPOSE: As healthcare providers are the main source of patient education, provider knowledge is crucial in teaching proper inhaler technique to patients. Published reports have previously shown inadequacy of inhaler technique knowledge among health care providers. We sought to assess inhaler technique in internal medicine residents and assess the efficacy of educational intervention. We used two educational tools - manual demonstration by a pulmonologist vs. an online video instruction. We decided to compare the effectiveness of both interventions by analyzing data collected during this educational experience.
METHODS: One of the didactic teaching sessions for internal medicine residents at a community hospital was dedicated to teaching metered dose inhaler (MDI) technique. One group was given a manual demonstration by a pulmonologist and other group was shown an online video (www.use-inhalers.com). Inhaler technique was assessed before and after instruction by video recording the inhaler use and scoring 1 point for each of 11 steps performed correctly. All assessments were done by one author (GG) who was blinded to pre/post sequence and to educational method used. Total inhaler scores were expressed as mean ± SD and comparisons were made using t-tests.
RESULTS: Of the 35 residents, 13 got manual demonstration and 22 got video instruction. Post instruction scores were significantly improved in both groups. Pre/post inhaler scores with manual demonstration were 6.54 ± 1.51 and 9.85 ± 1.41 (p=0.000002) and with video instruction were 6.09 ± 1.76 and 9.43 ± 2.21 (p=0.00009). The change in inhaler scores with manual demonstration (3.31 ± 1.38) and video instruction (3.35 ± 3.37) was not significant (p=0.48).
CONCLUSIONS: Similar to reports over several decades, most medical residents in our study were unable to use a MDI correctly. One educational session was highly effective and most residents were able to achieve a good to perfect technique. Instruction using an online video can effectively substitute manual demonstration without any impact on quality while saving on time and resources used.
CLINICAL IMPLICATIONS: Poor knowledge of inhaler technique in medical residents requires urgent attention. Adoption of instruction using an online video can make high quality instruction more accessible as same model can be employed for other health care providers too. As the same resource can be accessed at anytime, it can help reinforce the education over time, esp. if same resource is used by providers in educating their patients.
DISCLOSURE: Rakesh Gupta: Consultant fee, speaker bureau, advisory committee, etc.: Medical advisor to use-inhalers.com The following authors have nothing to disclose: Gunjan Gupta
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