Other Titles

Rising Star Poster/Presentation

Abstract

Mechanical ventilation management requires accurate interpretation of ventilator waveforms to identify patient-ventilator dyssynchrony, guide clinical decision-making, and prevent adverse patient outcomes. Although mechanical ventilation is fundamental to intensive care unit (ICU) practice, traditional training may not fully prepare clinicians to recognize and manage patient-ventilator asynchrony. Competency in waveform interpretation improves with repeated exposure, deliberate practice, and clinical reinforcement; however, few training programs provide structured approaches to support continued skill development. This quality improvement project evaluated whether a structured, case-based ventilator waveform microlearning intervention would improve confidence and support retention of knowledge in waveform interpretation among advanced practice provider (APP) fellows, including acute care nurse practitioners and physician assistants, and physician fellows managing critically ill patients receiving mechanical ventilation. A quasi-experimental pre/post design was used to assess confidence and knowledge retention following completion of a structured ventilator waveform microlearning program. Participants completed a series of brief, case-based waveform modules designed for review over time to promote spaced learning and deliberate practice. The Learning Self-Efficacy Scale (L-SES) measured confidence in ventilator management before and after the intervention. A validated knowledge assessment was administered at baseline and again following the intervention to evaluate retention of ventilator management knowledge. Forty participants completed the L-SES before and after the intervention, and thirty-five completed the knowledge assessment at both time points. There was a statistically significant increase in the mean L-SES scores following the intervention, indicating improved confidence in waveform interpretation and mechanical ventilation management. No statistically significant difference was observed between pre-test and post-test knowledge scores, suggesting knowledge remained stable over time. Incorporating spaced, case-based waveform education into critical care fellowship and APP training programs may enhance competency in mechanical ventilation management and improve readiness to independently manage critically ill patients.

Notes

References:

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Acho, M., Kriner, E., Sartain, N., Chatterjee, S., Sun, J., Lee, B., & Seam, N. (2022). Impact of a mechanical ventilation curriculum on respiratory therapist recognition of patient-ventilator asynchrony. Respiratory Care, 67(12), 1597–1602. https://doi.org/10.4187/respcare.09903

Alqahtani, J. S., AlAhmari, M. D., Alshamrani, K. H., Alshehri, A. M., Althumayri, M. A., Ghazwani, A. A., AlAmoudi, A. O., Alsomali, A., Alenazi, M. H., AlZahrani, Y. R., Alqahtani, A. S., AlRabeeah, S. M., & Arabi, Y. M. (2020). Patient-ventilator asynchrony in critical care settings: National outcomes of ventilator waveform analysis. Heart & Lung, 49(5), 630–636. https://doi.org/10.1016/j.hrtlng.2020.04.002

Centers for Disease Control and Prevention. (2025, January). Ventilator-associated event (VAE): For use in adult locations only. National Healthcare Safety Network. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.cdc.gov/nhsn/pdfs/pscmanua
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Hickey, S. M., Sankari, A., & Giwa, A. O. (2024). Mechanical ventilation. https://www.ncbi.nlm.nih.gov/books/NBK539742/

Karagiannidis, C., Krause, F., Bentlage, C., Wolff, J., Bein, T., Windisch, W., & Busse, R. (2024). In-hospital mortality, comorbidities, and costs of one million mechanically ventilated patients in Germany: A nationwide observational study before, during, and after the covid-19 pandemic. The Lancet Regional Health - Europe, 42, 100954. https://doi.org/10.1016/j.lanepe.2024.100954

Keller, M., Acho, M., Sun, J., Kriner, E., Seam, N., & Lee, B. W. (2024). Impact of longitudinal mechanical ventilation curriculum on decay of knowledge. ATS Scholar, 5(2), 302–310.
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Souza Leite, W., Novaes, A., Bandeira, M., Olympia Ribeiro, E., Dos Santos, A., de Moura, P., Morais, C., Rattes, C., Richtrmoc, M., Souza, J., Correia de Lima, G., Pinheiro Modolo, N., Goncalves, A., Ramirez Gonzalez, C., do Amparo Andrade, M., Dornelas DeAndrade, A., Cunha Brandão, D., & Lima Campos, S. (2020). Patient-ventilator asynchrony in conventional ventilation modes during short-term mechanical ventilation after cardiac surgery: Randomized clinical trial. Multidisciplinary respiratory medicine, 15(1), 650. https://doi.org/10.4081/mrm.2020.650

Walsh, M. M., Krusmark, M. A., Jastrembski, T., Hansen, D. A., Honn, K. A., & Gunzelmann, G. (2022). Enhancing learning and retention through the distribution of practice repetitions across multiple sessions. Memory & Cognition, 51(2), 455–472. https://doi.org/10.3758/s13421-022-01361-8

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Description

A structured, case-based ventilator waveform microlearning intervention was designed to improve confidence and support retention of knowledge in APP and physician fellows managing mechanically ventilated patients. Participants will learn how spaced, case-based education can strengthen waveform interpretation skills and support competency development in ICU training programs.

Author Details

Soraya Smith-Farmer, PhD, ACNP-BC, ACNPC, CCRN, NEA-BC

Dr. Soraya Smith-Farmer is a PhD-prepared acute care nurse practitioner and Doctor of Nursing Practice candidate in executive leadership with a clinical and academic background in critical care medicine, advanced practice provider education, and competency-based training. She serves as Lead Advanced Practice Provider in a medical intensive care unit and as a Clinical Assistant Professor teaching graduate nursing students. Her scholarly interests focus on mechanical ventilation education, clinical competency development, and improving outcomes among critically ill, high-acuity patient populations.

Sigma Membership

Alpha Epsilon, Tau Psi at-Large

Type

Poster

Format Type

Text-based Document

Study Design/Type

Quasi-Experimental Study, Other

Research Approach

Quantitative Research

Keywords:

Artificial Respiration, Patient-Ventilator Asynchrony, Mechanical Ventilators, Waveforms, Critical Care, Clinical Competence, Intensive Care Units, Professional Knowledge--Education

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Invited Presentation

Acquisition

Proxy-submission

Date of Issue

2026-10-01

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A Call to Standardization for Ventilator Waveform Education for APPs and Physician Fellows

Toronto, Ontario, Canada

Mechanical ventilation management requires accurate interpretation of ventilator waveforms to identify patient-ventilator dyssynchrony, guide clinical decision-making, and prevent adverse patient outcomes. Although mechanical ventilation is fundamental to intensive care unit (ICU) practice, traditional training may not fully prepare clinicians to recognize and manage patient-ventilator asynchrony. Competency in waveform interpretation improves with repeated exposure, deliberate practice, and clinical reinforcement; however, few training programs provide structured approaches to support continued skill development. This quality improvement project evaluated whether a structured, case-based ventilator waveform microlearning intervention would improve confidence and support retention of knowledge in waveform interpretation among advanced practice provider (APP) fellows, including acute care nurse practitioners and physician assistants, and physician fellows managing critically ill patients receiving mechanical ventilation. A quasi-experimental pre/post design was used to assess confidence and knowledge retention following completion of a structured ventilator waveform microlearning program. Participants completed a series of brief, case-based waveform modules designed for review over time to promote spaced learning and deliberate practice. The Learning Self-Efficacy Scale (L-SES) measured confidence in ventilator management before and after the intervention. A validated knowledge assessment was administered at baseline and again following the intervention to evaluate retention of ventilator management knowledge. Forty participants completed the L-SES before and after the intervention, and thirty-five completed the knowledge assessment at both time points. There was a statistically significant increase in the mean L-SES scores following the intervention, indicating improved confidence in waveform interpretation and mechanical ventilation management. No statistically significant difference was observed between pre-test and post-test knowledge scores, suggesting knowledge remained stable over time. Incorporating spaced, case-based waveform education into critical care fellowship and APP training programs may enhance competency in mechanical ventilation management and improve readiness to independently manage critically ill patients.