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Assessing airway management education for nonanesthesiologists
Abstracts
667
education in these areas, especially in regard to children [1]. The purpose of this study was to assess the medical students’ knowledge in pediatric pain management. Method: After institutional review board approval, third year medical students during their pediatric rotation participated in a pain management PBLD. Students completed a pretest consisting of 10 multiple choice questions (single response) assessing knowledge recognition/comprehension and a posttest consisting of 10 K-type questions (multiple response) assessing knowledge application [2]. Analysis was performed using paired t and Fisher exact tests. Results: Of the 87 students who have participated, 83 completed the pretest, and 86 completed the posttest. Table 1 contains test results. Groups II and IV, with complete data sets, were compared. Table 1
Medical student scores
Groups
n
Pretest, mean F SD
Posttest, mean F SD
Pretest, % passed
Posttest, % passed
I II III IV P
17 26 18 26
6.9 F 6.5 F 6.8 F 6.7 F 0.38a
6.0 F 1.5 6.3 F 1.8 6.6 F 1.5 7.2 F 1.4 0.034a
65 50 61 58 0.386b
30 50 35 77 0.041b
a b
1.1 1.3 1.7 1.6
Paired t test. Fisher exact test.
Maxillofacial Surgery (OMF), emergency medical technician, surgery, pediatrics, and dentistry) rotate through our pediatric anesthesiology department each year. This study assessed a 10-day program designed to increase the airway management (AM) proficiency of fellowship level trainees. Methods: A 10-day pediatric AM course included prerotation/ postrotation evaluation, readings, didactic lectures, and intraoperative teaching. The prerotation/postrotation evaluation consisted of a 15 multiple choice question quiz and 6-step Objective Structured Clinical Exam (OSCE). Participants also reported preexperience/postexperience with AM and confidence levels (5-point Likert scale [1]) for each skill. Results were compared using the Fisher exact and t tests. Results: After institutional review board approval, 10 fellows (7 intensive care unit, 2 emergency department, 1 surgery) completed the course. Table 1 contains the results. The passing rate (z60%) was 1% precourse and 60% postcourse ( P = 0.029). Discussion: Initial results demonstrate that a 10-day course significantly improved airway management skills and knowledge of nonanesthesiology fellows. Previous studies have shown that trainees require between 50 and 70 intubations to achieve proficiency [2,3]. We report a similar finding for critical number and a close relationship between OSCE success and confidence scores. doi:10.1016/j.jclinane.2005.09.039
Discussion: Pain management knowledge—recognition and comprehension—remained at consistently low level, whereas its application steadily improved among third year medical students in this study An increased effort is needed for acquiring basic knowledge as well as developing clinical application. doi:10.1016/j.jclinane.2005.09.038
References [1] Simon et al. Confidence in performance of pediatric emergency medicine procedures. Pediatr Emerg Care 1996;12:336 - 9. [2] Konrad et al. Learning manual skills in anesthesiology: is there a recommended number of cases? Anesth Analg 1998;86: 635 - 639. [3] Mulcaster JT, Mills J, Hung OR, et al. Laryngoscopic intubation: learning and performance. Anesthesiology 2003;98:23 - 7.
References [1] JCAHO 2003. [2] Medical Education 2004;38:974. [3] The American Surgeon 2000;66:470.
Retention of knowledge after an integrated 1-hour pediatric airway management course P. Dalby (MD), S. McCann (MD), M. Fiedor (MD) R. Romeo (MD), R. Patel (MD) University of Pittsburgh School of Medicine, Pittsburgh, PA
Assessing airway management education for nonanesthesiologists I.T. Cohen (MD) Children’s National Medical Center, Washington, DC Introduction: Approximately 30 nonanesthesiologists trainees (intensive care unit, emergency department, Oral
Table 1
Introduction: Pediatric residents who participate in a structured curriculum for pediatric resuscitation acquire greater knowledge, skills, confidence, and leadership than those who do not participate in a formal curriculum [1]. It is
Results of nonanesthesiologist airway management course
Evaluation categories
MCQ (out of 15), mean F SD
OSCE (out of 20), mean F SD
Total score (out of 35), mean F SD
No. of maneuvers, median
Confidence (out of 25), median
Precourse Postcourse P (t test)
8.3 F 2.8 12.7 F 1.5 b0.05
7.1 F 2.0 10.1 F 3.1 b0.05
15.4 F 4.0 22.8 F 3.9 b0.05
14 107 NA
10 16 NA
667
education in these areas, especially in regard to children [1]. The purpose of this study was to assess the medical students’ knowledge in pediatric pain management. Method: After institutional review board approval, third year medical students during their pediatric rotation participated in a pain management PBLD. Students completed a pretest consisting of 10 multiple choice questions (single response) assessing knowledge recognition/comprehension and a posttest consisting of 10 K-type questions (multiple response) assessing knowledge application [2]. Analysis was performed using paired t and Fisher exact tests. Results: Of the 87 students who have participated, 83 completed the pretest, and 86 completed the posttest. Table 1 contains test results. Groups II and IV, with complete data sets, were compared. Table 1
Medical student scores
Groups
n
Pretest, mean F SD
Posttest, mean F SD
Pretest, % passed
Posttest, % passed
I II III IV P
17 26 18 26
6.9 F 6.5 F 6.8 F 6.7 F 0.38a
6.0 F 1.5 6.3 F 1.8 6.6 F 1.5 7.2 F 1.4 0.034a
65 50 61 58 0.386b
30 50 35 77 0.041b
a b
1.1 1.3 1.7 1.6
Paired t test. Fisher exact test.
Maxillofacial Surgery (OMF), emergency medical technician, surgery, pediatrics, and dentistry) rotate through our pediatric anesthesiology department each year. This study assessed a 10-day program designed to increase the airway management (AM) proficiency of fellowship level trainees. Methods: A 10-day pediatric AM course included prerotation/ postrotation evaluation, readings, didactic lectures, and intraoperative teaching. The prerotation/postrotation evaluation consisted of a 15 multiple choice question quiz and 6-step Objective Structured Clinical Exam (OSCE). Participants also reported preexperience/postexperience with AM and confidence levels (5-point Likert scale [1]) for each skill. Results were compared using the Fisher exact and t tests. Results: After institutional review board approval, 10 fellows (7 intensive care unit, 2 emergency department, 1 surgery) completed the course. Table 1 contains the results. The passing rate (z60%) was 1% precourse and 60% postcourse ( P = 0.029). Discussion: Initial results demonstrate that a 10-day course significantly improved airway management skills and knowledge of nonanesthesiology fellows. Previous studies have shown that trainees require between 50 and 70 intubations to achieve proficiency [2,3]. We report a similar finding for critical number and a close relationship between OSCE success and confidence scores. doi:10.1016/j.jclinane.2005.09.039
Discussion: Pain management knowledge—recognition and comprehension—remained at consistently low level, whereas its application steadily improved among third year medical students in this study An increased effort is needed for acquiring basic knowledge as well as developing clinical application. doi:10.1016/j.jclinane.2005.09.038
References [1] Simon et al. Confidence in performance of pediatric emergency medicine procedures. Pediatr Emerg Care 1996;12:336 - 9. [2] Konrad et al. Learning manual skills in anesthesiology: is there a recommended number of cases? Anesth Analg 1998;86: 635 - 639. [3] Mulcaster JT, Mills J, Hung OR, et al. Laryngoscopic intubation: learning and performance. Anesthesiology 2003;98:23 - 7.
References [1] JCAHO 2003. [2] Medical Education 2004;38:974. [3] The American Surgeon 2000;66:470.
Retention of knowledge after an integrated 1-hour pediatric airway management course P. Dalby (MD), S. McCann (MD), M. Fiedor (MD) R. Romeo (MD), R. Patel (MD) University of Pittsburgh School of Medicine, Pittsburgh, PA
Assessing airway management education for nonanesthesiologists I.T. Cohen (MD) Children’s National Medical Center, Washington, DC Introduction: Approximately 30 nonanesthesiologists trainees (intensive care unit, emergency department, Oral
Table 1
Introduction: Pediatric residents who participate in a structured curriculum for pediatric resuscitation acquire greater knowledge, skills, confidence, and leadership than those who do not participate in a formal curriculum [1]. It is
Results of nonanesthesiologist airway management course
Evaluation categories
MCQ (out of 15), mean F SD
OSCE (out of 20), mean F SD
Total score (out of 35), mean F SD
No. of maneuvers, median
Confidence (out of 25), median
Precourse Postcourse P (t test)
8.3 F 2.8 12.7 F 1.5 b0.05
7.1 F 2.0 10.1 F 3.1 b0.05
15.4 F 4.0 22.8 F 3.9 b0.05
14 107 NA
10 16 NA