PURPOSE: Airway management is a complex, high risk area of critical care medicine. The ACCP Difficult Airway Management Course provides pulmonary / critical care physicians with an intensive simulation-based training experience to improve medical knowledge and procedural skills in airway management. We examined the impact of this training on learner performance.
METHODS: The Difficult Airway Course is a 2.5 day educational program that provides a variety of didactic, task trainer, and high fidelity simulation training modules to provide a hands-on experience with the preparation, teamwork, and tools necessary to manage airway emergencies. Participants complete a demographic survey, a self-assessment of airway management skills, and objective knowledge testing. Airway skills were assessed before and after the course, using a standardized high fidelity scenario with check list evaluation performed independently by 2 observers. Pre-and post course objective test scores were compared with paired t-tests. Procedural skills scores were compared with two-way repeated measures ANOVA. Interobserver agreement was evaluated with Pearson’s correlation coefficient.
RESULTS: Thirty-two learners with a wide variety of practice experience participated in the March and July 2009 courses. Learners reported significant improvements in clinical confidence at the end of the course. Pre- and post-course written assessments demonstrated an increase in the mean percentage of correct answers (64% + 15 SD vs 80% + 14 SD , p < 0.0001). Appropriate equipment preparation, patient positioning, and intubation steps were performed more frequently at the end of training (p < 0.0001) and mean time to intubation was decreased by 38% (10:55 min + 6:15 SD vs 6:45 min + 3:23 SD, p = 0.0005). Observer scoring during standardized high fidelity scenarios proved consistent (r = 0.8).
CONCLUSION: An intensive simulation course in difficult airway management improved intensivist confidence, procedural preparation and technical skill in airway management regardless of prior experience.
CLINICAL IMPLICATIONS: Further research is needed to determine if the medical knowledge and skills gained through this experience result in sustained practice changes and improved clinical outcomes.
DISCLOSURE: Alexander Niven, Other Honoraria for faculty participation from ACCP; No Product/Research Disclosure Information