Assistant Professor, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital.
Medical Director-TICU, Baylor College of Medicine and Texas Children's Hospital; Assistant Professor of Pediatrics, Department of Pediatric ICU, Texas Children's Hospital and Baylor College of Medicine.
MedEdPORTAL. 2020 Nov 3;16:11010. doi: 10.15766/mep_2374-8265.11010.
Patients receiving pediatric tracheostomy have significant risk for mortality due to compromised airway. Timely management of airway emergencies in children with tracheostomies is an important clinical skill for pediatricians. We developed this curriculum to improve residents' self-efficacy with tracheostomy management.
We collected baseline data on 67 residents from two hospitals while creating a blended curriculum with video-based instruction on routine tracheostomy change and team management of tracheostomy emergency. Forty residents enrolled in the curriculum. During an ICU rotation, they received face-to-face instruction on routine tracheostomy change in small groups, followed by assessment of managing a tracheostomy emergency during a simulation. A video completed prior to the simulation took 9 minutes, the routine tracheostomy change didactic session took 15 minutes, and the simulation instruction was completed in 10-15 minutes. We collected feedback on the effectiveness of the curriculum from the participants.
All 107 residents from the baseline and intervention groups completed the self-efficacy survey. The intervention group had significantly higher changes in scores across all self-efficacy domains than the baseline group. On the curriculum feedback survey, residents rated the curriculum very highly, between 4.4 and 4.8 on a 5-point Likert scale.
Our blended curriculum increased learners' self-efficacy and promoted learner competence in tracheostomy management. Residents scored more than 80% across all aspects of simulation assessment and reported higher self-efficacy scores following our curricular intervention.
接受小儿气管切开术的患者由于气道受损,死亡率较高。及时处理气管切开术儿童的气道急症是儿科医生的一项重要临床技能。我们开发了这个课程,以提高住院医师在气管切开术管理方面的自我效能感。
我们在两所医院收集了 67 名住院医师的基线数据,同时创建了一个包含常规气管切开术更换和气管切开术紧急情况团队管理的视频基础教学的混合课程。40 名住院医师参加了该课程。在 ICU 轮转期间,他们分组接受了常规气管切开术更换的面对面指导,然后在模拟中评估了处理气管切开术紧急情况的能力。在模拟之前完成的视频耗时 9 分钟,常规气管切开术更换教学课程耗时 15 分钟,模拟指导在 10-15 分钟内完成。我们从参与者那里收集了对课程有效性的反馈。
基线组和干预组的 107 名住院医师都完成了自我效能感调查。干预组在所有自我效能感领域的得分都显著高于基线组。在课程反馈调查中,住院医师对课程的评价非常高,在 5 分制的李克特量表上评分为 4.4 到 4.8。
我们的混合课程提高了学习者的自我效能感,促进了学习者在气管切开术管理方面的能力。在模拟评估的所有方面,住院医师的得分都超过了 80%,并报告在我们的课程干预后自我效能感得分更高。