Correa Jaqueline Betina Broenstrup, Dellazzana José Ernani Flores, Sturm Alexandre, Leite Dante Moore Almeida, de Oliveira Filho Getúlio Rodrigues, Xavier Rogério Gastal
Laboratório Experimental de Vias Aéreas e Pulmões do Centro de Pesquisas do Hospital de Clínicas de Porto Alegre (HCPA/ UFRGS) - Serviço de Pneumologia, Porto Alegre, RS.
Rev Bras Anestesiol. 2009 May-Jun;59(3):321-31. doi: 10.1590/s0034-70942009000300007.
Learning curves have proved to be useful tools to monitor the performance of a worker on a new assignment. Those curves have been used to evaluate several medical procedures. The objective of this study was to evaluate the learning of orotracheal intubation (OTI) with the Truview EVO2 laryngoscope with the CUSUM learning curve.
Four trainees underwent OTI training with the Truview EVO2 laryngoscope in a mannequin. They received orientation on the successful and failure criteria of OTI and alternated during the attempts, for a total of 300 OTI for each one. Four learning curves were plotted using the CUSUM cumulative addition method.
It was calculated that the 105 OTIs were necessary to achieve proficiency. The four trainees crossed the line of acceptable failure rate of 5% before completing 105 OTIs; the first trainee reached proficiency after 42 OTIs, the second and third after 56 OTIs, and the fourth after 97 OTIs, and from then on their performance remained constant. Differences in the success rate between residents and experienced anesthesiologists were not observed.
The CUSUM learning curve is a useful instrument to demonstrate objectively the ability when performing a new task. Laryngoscopy with the Truview EVO2 in a mannequin proved to be an easy procedure for physicians with prior experience in OTI; however, one should be cautious when transposing those results to clinical practice.
学习曲线已被证明是监测工人在新任务中表现的有用工具。这些曲线已被用于评估多种医疗程序。本研究的目的是使用累积和（CUSUM）学习曲线评估使用Truview EVO2喉镜进行经口气管插管（OTI）的学习情况。
四名学员在模拟人身上使用Truview EVO2喉镜进行OTI训练。他们接受了关于OTI成功和失败标准的培训，并在尝试过程中交替进行，每人总共进行300次OTI。使用CUSUM累积加法绘制了四条学习曲线。
经计算，达到熟练水平需要105次OTI。四名学员在完成105次OTI之前就越过了5%的可接受失败率线；第一名学员在42次OTI后达到熟练水平，第二名和第三名在56次OTI后达到熟练水平，第四名在97次OTI后达到熟练水平，从那时起他们的表现保持稳定。未观察到住院医师和经验丰富的麻醉医师之间成功率的差异。
CUSUM学习曲线是客观展示执行新任务时能力的有用工具。对于有OTI经验的医生来说，在模拟人身上使用Truview EVO2喉镜进行喉镜检查是一个简单的程序；然而，将这些结果应用于临床实践时应谨慎。
