Learning and recall of metered dose inhaler technique amongst junior medical residents in a teaching hospital

Objectives: to evaluate learning characteristics of mdi use amongst junior doctors and retention of the skills over few months' time. methods: fifty residents during their first rotation in medicine department were evaluated for baseline performance of 13 individual steps of mdi use. they were evaluated after group demonstration and further individualized training of difficult to learn steps. retention of technique was evaluated again at 3 months. evaluation was done by looking at demonstration video and recorded as correct/incorrect. results: no candidate in the beginning could demonstrate all steps correctly. this improved to 100% (p<0.05 for all) correct performance at all steps only after one-to-one demonstration sessions following group lecture. coordination of actuation of device with inspiration and continued inspiration thereafter were most difficult-to-learn steps requiring up to 3 demonstrations after group lecture in 62% and 68% of participants respectively. after 3 months,performance deteriorated (p<0.05) in 11 of 13 fully learned steps. in the above two difficult-to-learn steps it returned close to low level baseline conclusions: junior-most medical residents have grossly sub-optimal performance at steps of mdi use which improves only after individualized demonstration sessions but deteriorate rapidly close to baseline low in difficult-to-learn steps.