Ma Haobo, Ruan Xia, Wong Vanessa T, Guo Wenjuan, Huang Yuguang, Mitchell John D
J Educ Perioper Med. 2021 Jan 1;23(1):E655. doi: 10.46374/volxxiii_issue1_haoboma. eCollection 2021 Jan-Mar.
Fiberoptic intubation (FOI) is key in managing difficult airways. Good scope control increases efficiency and patient safety. Understanding the gap between novices and experts in scope control would help medical educators develop a feedback-based teaching approach for novices. We designed and used a checklist for evaluating the gap in fiberoptic scope control between novices and experts.
Twelve first-year anesthesiology residents (novice group) attended a lecture, followed by hands-on practice with a fiberoptic scope on a manikin. Five staff anesthesiologists (expert group) only did the hands-on practice. After practice, each participant was video-recorded while conducting an FOI on the manikin. Two senior anesthesiologists developed and used a 7-item checklist to assess the FOIs. Checklist scores and total times for FOIs were compared between groups using the Mann-Whitney test. Internal consistency of the checklist items, interrater reliability, and the relationship between checklist score and total time for FOI were assessed with Cronbach alpha, Cohen kappa, and the Pearson correlation coefficient, respectively.
Experts had higher checklist scores than novices ( = .0016). The item with the lowest success rate for novices (50%) was keeping the scope straight. Novices spent more time on the FOI than experts ( = .0005). Cronbach alpha, Cohen kappa, and the Pearson correlation coefficient were 0.8699, 0.75, and -0.9454, respectively.
Our checklist was used to detect differences in fiberoptic scope control skills between novices and experts. With a video-based assessment method, it can be used to develop a feedback-based teaching method for fiberoptic scope control.
纤维光导喉镜插管（FOI）是处理困难气道的关键。良好的喉镜控制可提高效率并保障患者安全。了解新手与专家在喉镜控制方面的差距，将有助于医学教育工作者为新手制定基于反馈的教学方法。我们设计并使用了一份清单来评估新手与专家在纤维光导喉镜控制方面的差距。
12名麻醉学一年级住院医师（新手组）参加了一场讲座，随后在模拟人上进行纤维光导喉镜的实践操作。5名麻醉科 staff 医师（专家组）仅进行了实践操作。实践后，每位参与者在模拟人上进行FOI时被录像。两名资深麻醉科医师制定并使用了一份包含7项内容的清单来评估FOI。使用Mann-Whitney检验比较两组之间的清单得分和FOI总时间。分别用Cronbach α系数、Cohen κ系数和Pearson相关系数评估清单项目的内部一致性、评分者间信度以及清单得分与FOI总时间之间的关系。
专家的清单得分高于新手（P = .0016）。新手成功率最低的项目（50%）是保持喉镜笔直。新手进行FOI的时间比专家长（P = .0005）。Cronbach α系数、Cohen κ系数和Pearson相关系数分别为0.8699、0.75和 -0.9454。
我们的清单用于检测新手与专家在纤维光导喉镜控制技能方面的差异。通过基于视频的评估方法，它可用于开发一种基于反馈的纤维光导喉镜控制教学方法。
