Objective structured clinical examination by means of an anesthesia simulation

Abstract

At the Iowa State University College of Veterinary Medicine, second year veterinary students are taught anaesthesia by means of lectures and anaesthesia laboratories. One of these laboratories in particular teaches the assembly and operation of the anaesthetic machine and drug calculations for patients. The students assemble the machine, do all the operational checks and calculate drug rates. In order to improve the students’ ability to identify components, assemble and operate the anaesthesia machine, an Objective Structured Clinical Examination (OSCE) was developed, that focused on thirteen critical aspects of the process. The OSCE was carried out by means of a Dispomed® complete unused anaesthetic machine and a RescueCritters® intubation simulator. The thirteen areas were: * identify anaesthetic machine components * describe components functions * identify breathing systems * calculate reservoir bag size * assemble rebreathing and non-rebreathing systems * leak test a rebreathing and non-rebreathing system * demonstrate gas supply knowledge * calculate fresh gas flow rates * list breathing system differences * calculate breathing system time constants * describe proper intubation protocols * demonstrate proper tracheal intubation * demonstrate proper endotracheal tube cuff inflation All second-year students (n=120) were examined by means of the OSCE. They were graded on a scale from 5 (superior) to 1 (deficient). Students that scored grades of 1 and 2 were considered unsatisfactory. Students that scored 3, 4 or 5 passed the examination. Ninety-four percent (113/120) of students passed the OSCE. In conclusion, the highest scoring focus areas involved mathematical calculations. The lowest scoring focus areas involved assembly and functional operation of the machine.