Title
A study titled “Usability and Operational Integration of Real-Time Ventilation Feedback in a Military Field Hospital Setting: A Mixed Methods Study” evaluated the use of a real-time manual ventilation feedback device in a simulated military field hospital environment.
The study examined how easy the Sotair® flow-limiting valve was to use and whether military medical personnel found it helpful during a simulated operational setting.
Nichole Berge, PhD, NRP; Xinzhi Zhang; Mark Brady, MD, MPH, FACEP
Abstract PDF
Presentation
Background
Manual ventilation is a fundamental skill in both U.S.-based healthcare and deployed medical settings. However, variations in provider experience and operational demands often lead to inconsistent performance.
While feedback-enabled tools can maintain accuracy, their acceptance among military medical personnel has been underexplored.
Objective
The objective of the study was to evaluate the usability, perceived usefulness, and impact on ventilation quality of a real-time feedback device (Sotair®) in a simulated field hospital environment during the 2025 Global Medic exercise.
Methods
The study used a mixed-methods design, combining data collection and participant feedback related to the Sotair flow-limiting valve (SafeBVM, Boston, MA).
Qualitative Data Collection
All military medical provider participants completed pre- and post-simulation interviews, with manual ventilation performance assessed through direct observation.
Quantitative Data Collection
Forty-five participants completed 60-second pre- and post-device ventilation trials for quantitative analysis.
Data Analysis
Qualitative data were analyzed thematically using the Technology Acceptance Model (TAM) framework.
Quantitative performance data were analyzed to evaluate the impact of feedback devices on ventilation consistency. Data from both sources were triangulated to provide a comprehensive understanding of device effectiveness and usability.
Results
The study included 70 military medical providers, including:
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EMTs (41%)
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Paramedics (29%)
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Registered nurses (14%)
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Physicians (9%)
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Respiratory therapists (3%)
Quantitative Findings
Accuracy in achieving the target tidal volume range (420–570 mL) increased from:
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36.9% at baseline
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47.6% with the device
This improvement was statistically significant (p = 0.003).
Qualitative Findings
Qualitative responses reflected:
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Improved awareness of ventilation quality
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Strong provider support for real-world implementation
In the simulated military field hospital environment, the Sotair real-time ventilation feedback device was associated with high perceived usefulness, favorable ease of use, and strong desire for integration into training and operational contexts.
Discussion and Conclusion
This study evaluated how easy a real-time manual ventilation feedback device (the Sotair flow-limiting valve) was to use and whether military medical personnel found it helpful in a simulated field hospital setting.
Quantitative findings showed that feedback devices improved tidal volume consistency and pressure delivery compared to no-feedback control.
Qualitatively, providers described the devices as intuitive and helpful, supporting future use in practice when paired with training.
These findings align with prior studies suggesting feedback improves performance in simulated clinical skills.
The study also identified several considerations:
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The quantitative sample size was limited (n = 45).
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The design was simulation-based, warranting caution when generalizing findings to live operations.
Future research should explore:
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Field implementation
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Clinical outcomes
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Long-term adoption
The study concluded that real-time ventilation feedback devices were associated with improved performance and high provider acceptance, supporting their integration into training and practice.
See Flow Control Training in Action
SafeBVM hosts CAPCE-accredited workshops on flow control in manual ventilation. These sessions explore how flow, pressure, volume, and inspiratory timing affect ventilation performance through case-based discussion.
The workshop utilizes SotairIQ as a visualization tool to demonstrate ventilation parameters and support training.
Learn more about upcoming workshops: