Baseline evaluation
Baseline evaluation consisted in the evaluation of IT theoretical knowledge and practical skills.
Theoretical knowledge evaluation: healthcare professionals were asked to fill-in a written test which included 8 questions regarding MDI IT (see Appendix I). Each correct answer scored 1 point, up to a total of 8 points.
Practical skills evaluation: participants were asked to perform IT with space chamber and facemask and with a space chamber with mouthpiece (with apnea). IT with a space chamber and facemask was to be performed with a mannequin. In the case of IT with a space chamber and mouthpiece, they were asked to perform IT themselves.
Evaluators fulfilled a checklist with the steps to be accomplished: 7 steps if facemask was used in addition to spacer and 10 steps if only spacer with mouthpiece was used (Table 1). Each step of the checklist performed correctly scored 1 point. Failing to perform any one of these steps or not performing IT according to patients’ age was evaluated as an inadequate technique.
Additionally, demographic information was recorded: age, professional category, years of experience in PED, asthmatic personal background, previous specific IT training and if they modified IT in their daily practice.