Effectiveness of Surgical Airway Training Lab and Assessment of Skill and Knowledge Fade in Surgical Airway Establishment Among Prehospital Providers

Abstract

Study Objective This study sought to establish effectiveness of a current surgical airway education program comprised of lecture based and hands on training utilizing cadavers. The secondary aim was to evaluate the presence and degree of knowledge and skill fade three months after the training. Methods Thirteen participants were recruited from an academic medical center-based helicopter emergency medical services program. Participants were assessed prior to training, immediately after training and three months after training using a multiple-choice exam and a timed evaluation of ability to establish a surgical airway on a pig trachea. Demographic data were interpreted to assess the impact of years of experience on knowledge and skill. Results Training was effective at increasing knowledge and skill, with a significant mean increase in multiple choice exam scores of 14.6 percentage points following training and a mean decrease in time to airway establishment of 26 seconds. The training was not consistently effective at yielding the ability to establish a surgical airway in less than a threshold of 40-seconds, with only 46% of participants able to do so. There was no evidence of statistically significant knowledge or skill fade at three months post training. Conclusion Surgical airway training which includes both didactic and clinical learning utilizing human cadavers is effective at increasing both knowledge, as evidenced by increased scores on a multiple-choice exam, and skill as indicated by a decrease in time necessary to establish a patent surgical airway. Additional training is needed to establish competency in consistently establishing surgical airways in less than 40-seconds. While no significant knowledge or skill fade is present at three months post training, further studies are needed to determine the time interval at which knowledge and skill fade become significant, and at what frequency training should occur to prevent such fade. This study sought to establish effectiveness of a current surgical airway education program comprised of lecture based and hands on training utilizing cadavers. The secondary aim was to evaluate the presence and degree of knowledge and skill fade three months after the training. Thirteen participants were recruited from an academic medical center-based helicopter emergency medical services program. Participants were assessed prior to training, immediately after training and three months after training using a multiple-choice exam and a timed evaluation of ability to establish a surgical airway on a pig trachea. Demographic data were interpreted to assess the impact of years of experience on knowledge and skill. Training was effective at increasing knowledge and skill, with a significant mean increase in multiple choice exam scores of 14.6 percentage points following training and a mean decrease in time to airway establishment of 26 seconds. The training was not consistently effective at yielding the ability to establish a surgical airway in less than a threshold of 40-seconds, with only 46% of participants able to do so. There was no evidence of statistically significant knowledge or skill fade at three months post training. Surgical airway training which includes both didactic and clinical learning utilizing human cadavers is effective at increasing both knowledge, as evidenced by increased scores on a multiple-choice exam, and skill as indicated by a decrease in time necessary to establish a patent surgical airway. Additional training is needed to establish competency in consistently establishing surgical airways in less than 40-seconds. While no significant knowledge or skill fade is present at three months post training, further studies are needed to determine the time interval at which knowledge and skill fade become significant, and at what frequency training should occur to prevent such fade.