BACKGROUND:Training in mechanical ventilation is a key goal in critical care fellowship education. Web-based simulators offer a cost-effective and readily available alternative to traditional on-site simulators. However, it is unclear how effective they are as teaching tools. In this study, we evaluated the test scores of fellows who underwent mechanical ventilation training by using a web-based simulator compared with fellows who used an on-site simulator during a mechanical ventilation course.METHODS:This was a nonrandomized controlled trial conducted as part of a mechanical ventilation course that involved 70 first-year critical care fellows. The course was identical except for the simulation technology used. One group of instructors used a traditional on-site simulator, the ASL 5000 Lung Solution (n = 39). The second group was instructed in using a web-based simulator, VentSim (n = 31). Each fellow completed a pre-course test and a post-course test by using a validated, case-based ventilator waveform examination that consisted of 5 questions with a total possible score of 100. The primary outcome was a comparison of the mean scores on the posttest between the 2 groups. The study was designed as a non-inferiority trial with a predetermined margin of 10 points.RESULTS:There was no significant difference in the mean ± SD pretest scores between the web-based and the on-site groups (21.1 ± 12.6 and 26.9 ± 13.6 respectively; P = .11). The mean ± SD posttest scores were 45.6 ± 25.0 for the web-based simulator and 43.4 ± 16.5 for on-site simulator (mean difference 2.2; one-sided 95% CI –7.0 to ∞; Pnon-inferiority = .02 [non-inferiority confirmed]). Changes in mean ± SD scores (posttest – pretest) were 25.9 ± 20.9 for the web-based simulator and 16.5 ± 15.9 for the on-site simulator (mean difference 9.4, one-sided 95% CI 0.9 to ∞; Pnon-inferiority < .001 [non-inferiority confirmed]).CONCLUSIONS:In the education of first-year critical care fellows on mechanical ventilation waveform analysis, a web-based mechanical ventilation simulator was non-inferior to a traditional on-site mechanical ventilation simulator.

We're putting two of the world's most luxurious racing simulators head-to-head: the ultra-premium $2 million Dynisma racing simulator against the more accessible $63,000 Prodrive model. Is the $2 million price tag justifiable? Join WIRED's deep dive into the features, specifications, design, and performance of each simulator to find out which one reigns supreme.Read more: https://www.wired.com/story/dynisma-worlds-most-expensive-racing-simulator-tested/Director: Anna O'DonohueDirector of Photography: Mateo Akira NotsukeEditor: Estan Esparza; Brady JacksonHost: Jeremy WhiteGuest: Geroge BoothbyCreative Producer: Christie GarciaLine Producer: Joseph BuscemiAssociate Producer: Amy HaskourProduction Manager: Peter BrunetteProduction Coordinator: Kevin BalashCasting Producer: Nicole FordSound Mixer: Michael PanayiotisProduction Assistant: Sasha NovitskiyFact-Checker: Mike DentPost Production Supervisor: Christian OlguinPost Production Coordinator: Ian BryantSupervising Editor: Doug LarsenAdditional Editor: Christopher Jones; Louville MooreAssistant Editor: Justin Symonds