Animal models and methodology of case simulation: effective strategy in the training of physicians, residents and nurses in the use of the intra-aortic balloon pump

Introduction

Intra-aortic balloon counter-pulsation (IABP) is standard of care in treatment of cardiogenic shock. In critical care units (CCUs), even in tertiary centers of high complexity, the low incidence of cases with indication for use of this device can hinder the training and maintenance of a well-trained medical and multiprofessional team, confident about the indications, implantation techniques and management of the IABP, translating into higher risk of complications. Thus, using the resources of experimentation and techniques of teaching methodology (role-playing), we conducted a practical training of skills in implantation and management of the IABP for doctors, residents and nurses.

Objectives

To describe a proposal for practical skills training in implantation and management of the IABP for doctors, residents and critical care specialized nurses.

Methods

Training was divided into two parts: (A) theoretical training: taught by medical cardiologists, with emphasis on the operation mechanism and indications for equipment usage; and (B) practical training: four steps were taken: (1) revision of insertion techniques (aided by multimedia resources combined with images of movie computer graphics illustrating the technical details); (2) insertion practical training, two pigs were used to check the correct positioning of the catheter tip by radioscopy; (3) triggering training; and (4) recognition and conduct face to real problems using the device – role-play method and simulator resources (identification and intervention in eight different medical scenarios were taught). We evaluate satisfaction and cognitive skills before and after the training period.

Results

Four residents, one critical care physician and eight critical care nurses were trained. The results of satisfaction assessment were excellent/good in all items evaluated. Pre-tests and post-tests performed with nurse professionals showed improvement in cognitive performance. Residents performed only post-tests and their performances were excellent.

Conclusion

The training performed, using multimedia and animal experimentation resources, based on modern teaching–learning methodological concepts is appropriate for the training of medical professionals and nurses who work in ICUs.