Abstract

ObjectivesTo utilize cumulative evaluation data of the pediatric airway management simulation-based learning course on knowledge and practical skills of residents in the Saudi Commission for Health Speciality (SCFHS) in order to measure its efficacy and areas for improvement.MethodsThe evaluation is a retrospective cohort study that compares pre- and post-test (knowledge and skills) of a pediatric airway management simulation course. The 2-day course has been conducted four times annually at CRESENT and is comprised of interactive lectures on airway management and crew resource management, a demonstration of fundamentals of intubation, three skill stations, and six case scenarios with debriefing. Our evaluation data includes all pediatric residents who attended the course between January and December 2015.ResultsForty-six residents participated, of whom 30 (65.2%) are male and 16 (34.78%) are female. Overall, there is statistically significant improvement between the pre-test and post-test knowledge and practical skill scores. The pre-test scores are significantly different between the four different resident levels with p values of 0.003 and <0.001 respectively. However, there are no statistically significant differences in the post-test scores among the four different resident levels with p values of 0.372 and 0.133 respectively. The practical skill assessment covers four main domains. Improvements were noted in pharmacology (811%), equipment setup (250%), intubation steps (200%), and patient positioning (130%). The post-test scores are similar in all practical skill categories for the four different residency levels.DiscussionOur outcome-based evaluation strategy demonstrated that residents met the course learning objectives. The pediatric airway management simulation course at CRESENT is effective in improving the knowledge and practical skills of pediatric residents. Although the greatest improvement is noted among junior residents, learners from different residency levels have comparable knowledge and practical skills at the end of the course. Things that can be improved based on our study results include stressing more the type and dosages of the medications used in airway management and mandating the course for all junior pediatric residents. Although residents scored well, specific knowledge and skill elements still led us to targeted areas for course excellence. Similar courses need to be integrated in the pediatric residency curriculum. Further research is needed to study skill retention and more importantly its impact on patients’ care. Although resource-intensive, the use of cumulative evaluation data helped to focus quality improvement in our courses.

Highlights

  • Airway management is a common procedure performed in the Pediatric Intensive Care Unit (PICU) and Emergency Department (ED)

  • This study shows the importance and effectiveness of the pediatric airway management simulation course for pediatric residents under Saudi Commission for Health Speciality (SCFHS) training programs

  • The pediatric airway management simulation course at CRESENT is effective in improving the knowledge and practical skills of pediatric residents

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Summary

Introduction

Ill patients frequently have significant cardiac and pulmonary disease and limited physiologic reserve [2, 3]. These complicating factors commonly result in significant preoxygenation difficulty, limitations in the choice and dose of commonly used induction and paralytic agents, and less time for intubation preparation and performance. The number of intubation attempts increases the risk of adverse tracheal intubation associated events such as severe hypoxia, hypotension and cardiac arrest [2, 6, 7]. It increases the risk of intraventricular hemorrhage in low birth weight neonates [8]

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