Abstract
BackgroundA longitudinal curriculum was developed in conjunction with anesthesiologists, otolaryngologists, emergency physicians and experts in medical simulation and education.MethodsResidents participated in four different simulation-based training modules using animal models, cadavers, task trainers, and crisis scenarios using high fidelity manikins. Scenarios were based on various clinical settings (i.e. emergency room, operating room) and were followed by video-assisted structured debriefings. Participants completed both a self-assessment questionnaire and an exit survey using five-point Likert scales.Results31 otolaryngology residents participated in the curriculum. Residents reported simulation training significantly improved technical skills such as tracheostomy, cricothyroidotomy and pediatric intubation (p < 0.05 for all). Non-technical skills, including communication, delegation and management were significantly improved on post-test surveys in simulated crisis scenarios (p < 0.05 for all). 90 (28/31) of participants found simulations to be very realistic. Junior residents placed increased value on didactic teaching and procedural skills, while senior residents on crisis scenarios. Survey results indicated that > 90% (28/31) of participants found the modules of the curriculum to be useful and would recommend them to others.ConclusionA longitudinal simulation-based medical curriculum can be an effective method to teach airway management and teamwork skills to otolaryngology residents.
Highlights
Otolaryngology–Head and Neck Surgery (OTL-HNS) is a discipline that plays an important role in the management of patients with an unstable, or potentially unstable, airway
We conducted a prospective pilot study examining the role of a simulation-based, airway crisis management curriculum for OTL-HNS residents
Curriculum overview The broad educational goal of the curriculum was to provide OTL-HNS residents with opportunities to learn to effectively and efficiently manage clinically relevant airway crisis situations
Summary
Otolaryngology–Head and Neck Surgery (OTL-HNS) is a discipline that plays an important role in the management of patients with an unstable, or potentially unstable, airway. OTL-HNS residents require the expertise to effectively and efficiently participate in airway crisis situations to ensure positive patient outcomes. Acute or impending airway obstructions are rare events. It is difficult to rely on ‘on-the-job training’ for OTL-HNS residents to obtain and maintain the critical skills of airway crisis management. Airway crisis situations are complex, dynamic and time-sensitive contexts that pose a significant threat to Nguyen et al Journal of Otolaryngology - Head and Neck Surgery (2019) 48:10 patient safety, and are a major source of preventable errors [3, 4]. Emphasis on clinical management of difficult airway cases and on acquisition of CRM skills. A longitudinal curriculum was developed in conjunction with anesthesiologists, otolaryngologists, emergency physicians and experts in medical simulation and education
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