Surgical cricothyroidostomy. Analysis and comparison between teaching and validation models of simulator models.

Akihito Inca Atahualpa Urdiales,Phillipe Abreu,Kassio Silva Temperly,Gabriela Tulio Struck,Cecilia Hissai Yaegashi,Flavio Saavedra Tomasich,Antônio Carlos Ligocki Campos,Camila Roginski Guetter

doi:10.1590/0100-6991e-20202522

Abstract

to compare the acquisition and retention of knowledge about surgical cricothyroidostomy by the rapid four-step technique (RFST), when taught by expository lecture, low fidelity and high-fidelity simulation models. ninety medical students at UFPR in the first years of training were randomized assigned into 3 groups, submitted to different teaching methods: 1) expository lectures, 2) low-fidelity simulator model, developed by the research team or 3) high-fidelity simulator model (commercial). The procedure chosen was surgical cricothyroidostomy using the RFST. Soon after lectures, the groups were submitted to a multiple-choice test with 20 questions (P1). Four months later, they underwent another test (P2) with similar content. Analysis of Variance was used to compare the grades of each group in P1 with their grades in P2, and the grades of the 3 groups 2 by 2 in P1 and P2. A multiple comparisons test (post-hoc) was used to check differences within each factor (test and group). Statistical significance was considered when p<0.05. Statistical analysis was performed in the statistical software R version 3.6.1. each group was composed of 30 medical students, without demographic differences between them. The mean scores of the groups of the expositive lecture, of the simulator of low fidelity model and of high-fidelity simulator model in P1 were, respectively, 75.00, 76.09, and 68.79, (p<0.05). In P2 the grades were 69.84, 75.32, 69.46, respectively, (p>0.05). the simulation of low fidelity model was more effective in learning and knowledge retention, being feasible for RFST cricothyroidostomy training in inexperienced students.

Highlights

Medical education has traditionally been based on teachings centered on teachers, reading scientific evidence and performing procedures on cadavers, animals or real patients[1,2]
In the last twenty years, new ethical concepts have emerged in the society, which have influenced health education
This study and that of Kennedy et al demonstrated that training programs in advanced, simulation-based airway management are more effective than expository or video classes[40]

Summary

Introduction

Medical education has traditionally been based on teachings centered on teachers, reading scientific evidence and performing procedures on cadavers, animals or real patients[1,2]. In this teaching model, students acquire a satisfactory theoretical basis; there is a perception of lag in terms of practical experiences[3]. Situations like “learning by doing” or training in animals are not more acceptable in the most developed countries[6,7] It is precisely in this educational dilemma, between the need for practical training and patient safety, that medical simulation fits[8,9]. Simulation is defined as the replacement or reproduction of real situations through scenarios carefully constructed to evoke interactive responses from the student[2,8]

Objectives

Methods

Results

Conclusion