Jiang Aiyang A, Wardi Gabriel, Sweeney Daniel A
Division of Pulmonary, Critical Care and Sleep Medicine.
Department of Medicine, and.
ATS Sch. 2024 May 31;5(3):442-450. doi: 10.34197/ats-scholar.2023-0125IN. eCollection 2024 Sep 30.
Expert airway management is an essential skill for pulmonary and critical care fellows. Providing high-quality real-time feedback to trainees performing emergent intubations is often limited because of the acuity of the situation and the lack of full airway visualization by the supervising provider.
We sought to improve the quality of airway management education in a pulmonary and critical care fellowship training program by recording all emergent intubations and systematically reviewing select videos at a regularly scheduled airway management conference.
We introduced several modifications to our airway training curriculum, including the recording of all fellow-performed emergent tracheal intubations along with a regularly scheduled conference in which selected videos recordings were systematically reviewed. Surveys completed by trainees before and after the redesign of the curriculum were used to determine the efficacy of the individual curriculum modifications. Paired Student's tests, χ tests, and Kruskal-Wallis tests were used for statistical analysis. A value lower than 0.05 was considered significant in all analyses.
After completion of the redesigned curriculum, trainees (100% response rate) demonstrated improved technical knowledge ( < 0.04) and procedural confidence ( < 0.04) with regard to airway management. Of the modifications incorporated into the curriculum redesign, fellows ranked the video-recorded intubation review conference as the most beneficial ( = 0.001) of the educational interventions.
Recording of trainee-performed intubations and subsequent review of these videos using a standardized rubric was a highly valued modification to our fellowship airway training curriculum.
专业气道管理是肺科与重症医学专科培训学员的一项基本技能。由于情况紧急且监督人员无法完全看清气道,因此在为进行紧急插管的学员提供高质量实时反馈方面往往存在限制。
我们试图通过记录所有紧急插管情况,并在定期召开的气道管理会议上系统地审查选定视频,来提高肺科与重症医学专科培训项目中的气道管理教育质量。
我们对气道培训课程进行了多项改进,包括记录所有学员进行的紧急气管插管,并定期召开会议,在会上系统地审查选定的视频记录。通过学员在课程重新设计前后完成的调查问卷来确定各项课程改进措施的效果。采用配对学生 t 检验、χ²检验和 Kruskal-Wallis 检验进行统计分析。所有分析中,P 值低于 0.05 被认为具有统计学意义。
在完成重新设计的课程后,学员(回复率 100%)在气道管理方面的技术知识(P<0.04)和操作信心(P<0.04)均有所提高。在课程重新设计中纳入的各项改进措施中,学员将视频记录插管审查会议列为最有益的教育干预措施(P = 0.001)。
记录学员进行的插管操作,并随后使用标准化评分标准对这些视频进行审查,是我们专科气道培训课程中一项非常有价值的改进。