Abstract
Objectives:To report experience with a global multidisciplinary tracheostomy e-learning initiative.Methods:An international multidisciplinary panel of experts convened to build a virtual learning community for tracheostomy care, comprising a web-based platform, five distance learning (interactive webinar) sessions, and professional discourse over 12 months. Structured pre- and post-webinar surveys were disseminated to global participants including otolaryngologists, intensivists, nurses, allied health professionals, and patients/caregivers. Data were collected on audio-visual fidelity, demographics, and pre- and post-tutorial assessments regarding experience and skill acquisition. Participants reported confidence levels for NICU, pediatric, adult, and family care, as well as technical skills, communication, learning, assessment, and subdomains.Results:Participants from 197 institutions in 22 countries engaged in the virtual education platform, including otolaryngologists, speech pathologists, respiratory therapists, specialist nurses, patients, and caregivers. Significant improvements were reported in communication (P < .0001), clinical assessments (P < .0001), and clinical governance (P < .0001), with positive impact on pediatric decannulation (P = .0008), adult decannulation (P = .04), and quality improvement (P < .0001). Respondents reported enhanced readiness to integrate knowledge into practice. Barriers included time zones, internet bandwidth, and perceived difficulty of direct clinical translation of highly technical skills. Participants rated the implementation highly in terms of length, ability for discussion, satisfaction, applicability to professional practice, and expertise of discussants (median scores: 4, 4, 4, 4 and 5 out of 5).Conclusions:Virtual learning has dominated the education landscape during COVID-19 pandemic, but few data are available on its effectiveness. This study demonstrated feasibility of virtual learning for disseminating best practices in tracheostomy, engaging a diverse, multidisciplinary audience. Learning of complex technical skills proved a hurdle, however, suggesting need for hands-on experience for technical mastery. While interactive videoconferencing via webinar affords an engaging and scalable strategy for sharing knowledge, further investigation is needed on clinical outcomes to define effective strategies for experiential online learning and virtual in-service simulations.
Highlights
Patients with tracheostomies have complex needs, and when these patients suffer airway-related adverse events, they can deteriorate rapidly, risking life-threatening complications
The significant improvements around perceived knowledge and skills support virtual education in otolaryngology, with the caveat that a lack of impact was observed in technical skills
The pervasive use of technology for virtual communication that has been a necessity in a time of social distancing will have a lasting effect across the continuum of medical education, residency, and continuing medical education
Summary
Patients with tracheostomies have complex needs, and when these patients suffer airway-related adverse events, they can deteriorate rapidly, risking life-threatening complications. Slow dissemination of best practices has been a major barrier to high quality tracheostomy care, despite the notable successes of multidisciplinary tracheostomy care.[1,2,3,4] A critical knowledge gap in the United States and abroad[5] is how to drive large-scale improvement in care. In the era of COVID-19, the stakes are greatly increased, as healthcare workers have risk of infectious transmission from aerosol generating procedures and routine care related to tracheostomy
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