Medical Education Online (Dec 2022)

‘Involve me and I learn’: an experiential teaching approach to improve dyspnea awareness in medical residents

  • Maxens Decavèle,
  • Laure Serresse,
  • Frédérick Gay,
  • Nathalie Nion,
  • Sophie Lavault,
  • Yonathan Freund,
  • Marie-Cécile Niérat,
  • Olivier Steichen,
  • Alexandre Demoule,
  • Capucine Morélot-Panzini,
  • Thomas Similowski

DOI
https://doi.org/10.1080/10872981.2022.2133588
Journal volume & issue
Vol. 27, no. 1

Abstract

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Background Dyspnea is a frightening and debilitating experience. It attracts less attention than pain (‘dyspnea invisibility’), possibly because of its non-universal nature. We tested the impact of self-induced experimental dyspnea on medical residents.Materials and Methods During a teaching session following the principles of experiential learning, emergency medicine residents were taught about dyspnea theoretically, observed experimental dyspnea in their teacher, and personally experienced self-induced dyspnea. The corresponding psychophysiological reactions were described. Immediate and 1-year evaluations were conducted to assess course satisfaction (overall 0–20 grade) and the effect on the understanding of what dyspnea represents for patients.Results Overall, 55 emergency medicine residents participated in the study (26 men, median age 26 years). They were moderately satisfied with previous dyspnea teaching (6 [5–7] on a 0–10 numerical rating scale [NRS]) and expressed a desire for an improvement in the teaching (8 [7–9]). Immediately after the course they reported improved understanding of patients’ experience (7 [6–8]), which persisted at 1 year (8 [7–9], 28 respondents). Overall course grade was 17/20 [15–18], and there were significant correlations with experimental dyspnea ratings (intensity: r = 0.318 [0.001–0.576], p = 0.043; unpleasantness: r = 0.492 [0.208–0.699], p = 0.001). In multivariate analysis, the only factor independently associated with the overall course grade was ‘experiential understanding’ (the experimental dyspnea-related improvement in the understanding of dyspneic patients’ experience). A separate similar experiment conducted in 50 respiratory medicine residents yielded identical results.Conclusions This study suggests that, in advanced medical residents, the personal discovery of dyspnea can have a positive impact on the understanding of what dyspnea represents for patients. This could help fight dyspnea invisibility.

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