97 Impact of Virtual Simulation to Teach Paramedics Respiratory Failure Management During the COVID-19 Pandemic

McNally, K.; Walker, A.; Elahi, N.; Ganti, L.; Patel, P.; Vera, A.; Van Dillen, C.

Study Objectives: Continuing education for EMS personnel is often limited to online lectures and self-study, as educational resources vary from department to department. Moreover, social distancing measures during the current COVID-19 pandemic further limit the ability for in-person training experiences. Simulation, unlike traditional forms of online learning, allows educators to create specific learning objectives and reinforce clinical concepts through a scenario and debrief, in an environment that does not compromise patient safety. Traditionally simulation is performed in-person, however given the need to socially distance, virtual simulation has been proposed in various forms as an educational tool. The aim of our study was to determine the impact of virtual simulation to teach EMS personnel respiratory failure management. We also explored their perceptions of this learning experience in comparison to other training modalities. This study presents a unique way to provide education to paramedics during the Coronavirus pandemic, without some of the logistical concerns that accompany traditional in-person simulation. Methods: In total 90 Kissimmee Fire Department (KFD) personnel underwent a virtual simulation on respiratory failure. The participants were divided in groups of 3-6 with a designated team leader. Each session was virtually conducted by a physician. The physician facilitator was remotely broadcasted to the EMS team, performing tasks on a mannequin in the physician’s broadcasted room as dictated by the EMS team and providing vital signs. Each session was approximately 25 minutes with 15 minutes of case progression and 10 minutes of debrief. 42 EMS personnel then participated in a 13 question survey to determine how the simulation affected their comfort level with respiratory failure in both COVID-19 patients and non-COVID-19 patients. They also recorded feedback on the virtual simulation and any issues they might have had during the sessions. Results: The 42 EMS personnel responding to the survey felt an increased comfort level in managing respiratory failure in a suspected or known COVID-19 patient after the virtual simulation. There was an increase in “extremely comfortable” responses from 24% to 43% before and after the simulation, and a decrease in “somewhat uncomfortable” responses from 10% to 0%. There was a slight increase in the comfortability of managing respiratory non-COVID-19 patients as well, with an increase in “extremely comfortable” responses from 40% to 48%, and a decrease of “somewhat uncomfortable” responses from 2% to 0%. Only 12% of the responders stated they underwent simulation training once a month or more. In general 86% of the responders felt the video platform was easy to use, and the most common technical difficulty involved audio issues. Conclusions: EMS personnel undergoing a virtual simulation and debrief in the management of respiratory failure in the setting of the COVID-19 pandemic felt more comfortable in their management of these patients after their sessions. The majority recommended continuing this type of training in the future in survey responses. Our cohort had extensive EMS experience, but did not frequently undergo simulation training, which highlights a potential area of improvement for EMS education. First responders continue to be essential in the safe and effective management of COVID-19 patients, and virtual simulation is a viable option to facilitate EMS training. [Formula presented]