Department of Otolaryngology-Head and Neck Surgery, Georgetown University Medical Center, Washington, DC 20007, USA.
Laryngoscope. 2011 Oct;121(10):2114-21. doi: 10.1002/lary.22146. Epub 2011 Sep 6.
OBJECTIVES/HYPOTHESIS: Incoming otolaryngology residents are expected to triage and manage airway, bleeding, and other emergencies with little prior experience. Simulation-based education has become increasingly important as it provides tools to develop psychomotor skills and judgment early in residency, using realistic experiences while eliminating patient risk. We hypothesize that a Boot Camp course emphasizing basic otolaryngology management will increase participants' confidence and be perceived as useful in developing their knowledge, technical skills, self-confidence, and improving clinical performance, both immediately and 6 months following the course.
Survey.
A 1-day Boot Camp was developed consisting of six technical skills stations (mask ventilation, intubation, flexible laryngoscopy, microlaryngoscopy/bronchoscopy, epistaxis control, and cricothyroidotomy); a session involving telephone inquiry triage, and two complex airway scenarios addressing medical management and emphasizing team leadership. Residents completed questionnaires before, immediately, and 6 months following course completion.
Thirty residents enrolled, 27 participated in the course, and 24 completed all three surveys. Previous experiences and confidence levels were variable; 26 of 30 (87%) identified emergency airway management as a concern before attending the course. A Fisher's exact test demonstrated improved confidence (P < .05) for every skill. An overwhelming majority of participants agreed or strongly agreed the intervention was useful in developing their knowledge, technical skills, self-confidence, and improving clinical performance.
An intensive, simulation-based Boot Camp addressing airway, bleeding, and other otolaryngology emergencies was successful in improving junior otolaryngology residents' confidence and was perceived as useful in developing knowledge, technical skills, self-confidence, and improving clinical performance.
目的/假设:耳鼻喉科住院医师期望在几乎没有先前经验的情况下对气道、出血和其他紧急情况进行分诊和管理。基于模拟的教育变得越来越重要,因为它提供了工具,可以在住院医师早期发展运动技能和判断力,使用真实的经验,同时消除患者风险。我们假设,强调基本耳鼻喉科管理的训练营课程将提高参与者的信心,并被认为有助于发展他们的知识、技术技能、自信,并在课程结束后立即和 6 个月内提高他们的临床表现。
调查。
开发了为期 1 天的训练营,包括 6 个技术技能站(面罩通气、插管、软喉镜、显微喉镜/支气管镜、鼻出血控制和环甲切开术);一个涉及电话询问分诊和两个复杂气道场景的会议,涉及医疗管理和强调团队领导。住院医师在课程完成前、完成时和完成后 6 个月完成问卷。
30 名住院医师报名,27 名参加了课程,24 名完成了所有 3 次调查。先前的经验和信心水平各不相同;30 名中的 26 名(87%)在参加课程之前认为紧急气道管理是一个问题。Fisher 精确检验显示,每个技能的信心都有所提高(P <.05)。绝大多数参与者同意或强烈同意干预措施有助于发展他们的知识、技术技能、自信和提高临床表现。
一项强化、基于模拟的训练营课程,涵盖气道、出血和其他耳鼻喉科急症,成功地提高了初级耳鼻喉科住院医师的信心,并被认为有助于发展知识、技术技能、自信和提高临床表现。