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A Brief Simulation-Based Training Course Significantly Improves Physician Skill in Airway Management
October 2010, Vol 138, No. 4_MeetingAbstracts Slide Presentations: Tuesday, November 2, 2010 | October 2010
A Brief Simulation-Based Training Course Significantly Improves Physician Skill in Airway Management Eleanor M. Summerhill; Kevin C. Doerschug, MD; Alexander S. Niven, MD Alpert School of Medicine of Brown University, Pawtucket, RI Chest. 2010;138(4_MeetingAbstracts):832A. doi:10.1378/chest.9883 Abstract PURPOSE: Decreased patient physiologic reserves and other factors make airway management a complex, high risk area of critical care medicine practice. The ACCP offers a 2.5 hour simulation-based course in airway management at its CHEST annual session. This course provides an intensive training experience to enhance clinical knowledge, technical, and teamwork skills. We examined the impact of this training on learner performance. METHODS: The CHEST Airway Management Course includes both task trainer and high fidelity training modules. Participants complete a demographic survey, a self-assessment of airway management skills, and objective knowledge testing pre- and post-course. Learners are divided into teams of 4-5 each. Half the teams review equipment set-up, bag-valve-mask ventilation, induction pharmacology, and direct laryngoscopy utilizing task trainers. The remainder of the groups train together in teams utilizing crew resource management strategies in 3-5 standardized high-fidelity simulated airway scenarios. Each scenario is scored by faculty using a 21 point procedural checklist. At the midpoint of each session, groups switch stations. RESULTS: One hundred and ten learners participated in the October 2009 course. Scores were compared between first and third scenarios and across groups using 2-way repeated measures ANOVA. All groups performed significantly better in the third (66% ± 14% SD) vs. first scenario (55% ± 11% SD; P=0.0004). The effect of simulation training was similar in the groups that underwent task training first compared to those completing simulations first (P=0.17). Nevertheless, during the third scenario participants who received task training first scored significantly better overall compared to those who underwent simulation training first ( 70% ± 11% SD vs. 61% ± 16% SD; P=0.017). CONCLUSION: A brief, intensive simulation course improved airway management skills. Task training and high-fidelity simulation training provide complementary experiences to enhance learner competence in airway management. CLINICAL IMPLICATIONS: Further research is needed to determine if procedural skills gained through this experience translate to the clinical setting. DISCLOSURE: Eleanor Summerhill, No Financial Disclosure Information; No Product/Research Disclosure Information 2:30 PM - 3:45 PM
A Brief Simulation-Based Training Course Significantly Improves Physician Skill in Airway Management Eleanor M. Summerhill; Kevin C. Doerschug, MD; Alexander S. Niven, MD Alpert School of Medicine of Brown University, Pawtucket, RI Chest. 2010;138(4_MeetingAbstracts):832A. doi:10.1378/chest.9883 Abstract PURPOSE: Decreased patient physiologic reserves and other factors make airway management a complex, high risk area of critical care medicine practice. The ACCP offers a 2.5 hour simulation-based course in airway management at its CHEST annual session. This course provides an intensive training experience to enhance clinical knowledge, technical, and teamwork skills. We examined the impact of this training on learner performance. METHODS: The CHEST Airway Management Course includes both task trainer and high fidelity training modules. Participants complete a demographic survey, a self-assessment of airway management skills, and objective knowledge testing pre- and post-course. Learners are divided into teams of 4-5 each. Half the teams review equipment set-up, bag-valve-mask ventilation, induction pharmacology, and direct laryngoscopy utilizing task trainers. The remainder of the groups train together in teams utilizing crew resource management strategies in 3-5 standardized high-fidelity simulated airway scenarios. Each scenario is scored by faculty using a 21 point procedural checklist. At the midpoint of each session, groups switch stations. RESULTS: One hundred and ten learners participated in the October 2009 course. Scores were compared between first and third scenarios and across groups using 2-way repeated measures ANOVA. All groups performed significantly better in the third (66% ± 14% SD) vs. first scenario (55% ± 11% SD; P=0.0004). The effect of simulation training was similar in the groups that underwent task training first compared to those completing simulations first (P=0.17). Nevertheless, during the third scenario participants who received task training first scored significantly better overall compared to those who underwent simulation training first ( 70% ± 11% SD vs. 61% ± 16% SD; P=0.017). CONCLUSION: A brief, intensive simulation course improved airway management skills. Task training and high-fidelity simulation training provide complementary experiences to enhance learner competence in airway management. CLINICAL IMPLICATIONS: Further research is needed to determine if procedural skills gained through this experience translate to the clinical setting. DISCLOSURE: Eleanor Summerhill, No Financial Disclosure Information; No Product/Research Disclosure Information 2:30 PM - 3:45 PM