Cumulative evaluation data: pediatric airway management simulation courses for pediatric residents

被引:4
作者
Alyousef S. [1 ,2 ]
Marwa H. [1 ]
Alnojaidi N. [4 ]
Lababidi H. [2 ]
Bashir M.S. [3 ]
机构
[1] Specialized Children Hospital, King Fahad Medical City, Riyadh
[2] Center for Research, Education & Simulation Enhanced Training (CRESENT), King Fahad Medical City, Riyadh
[3] Research Center, King Fahad Medical City, Riyadh
[4] Al-Maarefa Medical University, Riyadh
关键词
Cumulative Evaluation Data; Intubation Steps; Pediatric Airway Management; Practical Skills Assessment; Simulation Course;
D O I
10.1186/s41077-017-0044-3
中图分类号
学科分类号
摘要
Objectives: To utilize cumulative evaluation data of the pediatric airway management simulation-based learning course on knowledge and practical skills of residents in the Saudi Commission for Health Speciality (SCFHS) in order to measure its efficacy and areas for improvement. Methods: The evaluation is a retrospective cohort study that compares pre- and post-test (knowledge and skills) of a pediatric airway management simulation course. The 2-day course has been conducted four times annually at CRESENT and is comprised of interactive lectures on airway management and crew resource management, a demonstration of fundamentals of intubation, three skill stations, and six case scenarios with debriefing. Our evaluation data includes all pediatric residents who attended the course between January and December 2015. Results: Forty-six residents participated, of whom 30 (65.2%) are male and 16 (34.78%) are female. Overall, there is statistically significant improvement between the pre-test and post-test knowledge and practical skill scores. The pre-test scores are significantly different between the four different resident levels with p values of 0.003 and <0.001 respectively. However, there are no statistically significant differences in the post-test scores among the four different resident levels with p values of 0.372 and 0.133 respectively. The practical skill assessment covers four main domains. Improvements were noted in pharmacology (811%), equipment setup (250%), intubation steps (200%), and patient positioning (130%). The post-test scores are similar in all practical skill categories for the four different residency levels. Discussion: Our outcome-based evaluation strategy demonstrated that residents met the course learning objectives. The pediatric airway management simulation course at CRESENT is effective in improving the knowledge and practical skills of pediatric residents. Although the greatest improvement is noted among junior residents, learners from different residency levels have comparable knowledge and practical skills at the end of the course. Things that can be improved based on our study results include stressing more the type and dosages of the medications used in airway management and mandating the course for all junior pediatric residents. Although residents scored well, specific knowledge and skill elements still led us to targeted areas for course excellence. Similar courses need to be integrated in the pediatric residency curriculum. Further research is needed to study skill retention and more importantly its impact on patients’ care. Although resource-intensive, the use of cumulative evaluation data helped to focus quality improvement in our courses. © 2017, The Author(s).
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共 23 条
[1]  
Reynolds S.F., Heffner J., Airway management of the critically ill patient, Chest, 1, 4, pp. 1397-1412, (2005)
[2]  
Walz J.M., Zayarumy M., Heard S.O., Airway management in critical illness, Chest, 13, 2, pp. 608-620, (2007)
[3]  
Jaber S., Amraoui J., Lefrant J.Y., Et al., Clinical practice and risk factors for immediate complications of endotracheal intubation in the intensive care unit: a prospective, multiple-center study, Critical Care Med, 34, 9, pp. 2355-2361, (2006)
[4]  
Jabre P., Combes X., Lapostolle F., Et al., Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicenter randomized controlled trial, Lancet, 374, 9686, pp. 293-300, (2009)
[5]  
Samsoon G.L., Young J.R., Difficult tracheal intubation: a retrospective study, Anaesthesia, 42, 5, pp. 487-490, (1987)
[6]  
Lee J.H., Turner D.A., Kamat P., Nett S., Shults J., Nadkarni V.M., Nishisaki A., The number of tracheal intubation attempts matters! A prospective multi-institutional pediatric observational study, BMC Pediatr, 16, (2016)
[7]  
Barch B., Rastatter J., Jagannathan N., Difficult pediatric airway management using the intubating laryngeal airway, Int J Pediatr Otorhinolaryngol, 76, 11, pp. 1579-1582, (2012)
[8]  
Sauer C.W., Kong J.Y., Vaucher Y.E., Finer N., Proudfoot J.A., Boutin M.A., Leone T.A., Intubation attempts increase the risk for severe intraventricular hemorrhage in preterm infants. A retrospective cohort study, J Pediatr, 177, pp. 108-113, (2016)
[9]  
Fitzpatrick J., Sanders J., Worthen B., Program evaluation: alternative approaches and practical guidelines, (2011)
[10]  
Blanchard R., Torbeck L., Blondeau W., AM last page: a snapshot of three common program evaluation approaches for medical education, Acad Med, 88, 1, (2013)