Education, Teaching, and Quality Improvement |

Airway Management Boot Camp for Incoming Critical Care Fellows - A Simulation Study FREE TO VIEW

Alfredo Lee Chang, MD; Akiva Dym; Carla Venegas-Borsellino, MD; Maneesha Bangar, MD; Nida Qadir, MD; Adam Keene, MD; Lewis Eisen, MD
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Montefiore Medical Center, Bronx, NY

Chest. 2015;148(4_MeetingAbstracts):460A. doi:10.1378/chest.2278926
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SESSION TITLE: Education and Simulation

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Airway management is an essential skill for the intensivist. It is a complex process requiring rapid integration of medical knowledge, technical skills, and critical thinking. Traditional training of house officers may be inadequate to teach the incorporation of these skills. We hypothesize that simulation training will have a positive impact on critical thinking skills in airway management.

METHODS: This is a prospective study of 18 incoming Critical Care fellows at an academic urban medical center. A 10 item questionnaire was provided before and after 6 hours of hands on simulator training using the SimMan, basic simulators for CPR and airway training mannequins. The scenarios included a basic clinical vignette with a management decision; this was graded based on disagreement or agreement of the management from 0-100 percentile. A Wilcoxon Matched-pair Signed-Rank test was used to compare difference in the means. P<0.05 was considered statistically significant. SPSS21 was used for statistical analysis.

RESULTS: Eighteen fellows completed the pre-intervention questionnaire and 17 completed the post-intervention questionnaire (due to research subject choice). The median total agreement in the pre and post intervention questionnaire was: [25(IQR62.5) vs. 75(IQR25), p= 0.002]. The most marked improvements were in: ability to use paralytics [25(IQR18.75-75) vs 75(IQR75-100), p=0.038] and ability to obtain a surgical airway in a cannot bag and cannot intubate scenario [50(IQR25-75) vs 100(IQR75-100), p=0.019].

CONCLUSIONS: Simulation training significantly improved airway management and overall scores in the critical thinking questionnaire. It is an effective training method for these potentially high risk events.

CLINICAL IMPLICATIONS: Simulation training improves critical thinking and thus may improve patient safety.

DISCLOSURE: The following authors have nothing to disclose: Alfredo Lee Chang, Akiva Dym, Carla Venegas-Borsellino, Maneesha Bangar, Nida Qadir, Adam Keene, Lewis Eisen

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