Airway skills training using a human patient simulator

Abstract

Background: Airway skills education is important for the safe and effective care of patients. Interns often encounter critical airway situations. Their ability to cope derives from the recall of formal lectures and tutorials, as well as accumulated experience. We tested whether human patient simulators enabled trainees to enhance skills and knowledge in a safe and realistic environment.
Method: An airway training programme was developed using a high-fidelity lifelike human patient simulator (METI®) to simulate realistic airway scenarios. An equivalent programme using traditional methods (lectures and tutorials) contained the same information. A written assessment [(multiple-choice questions (MCQ)] and four assessment stations [objective structured clinical examination (OSCE)] were administered before and after instruction. A questionnaire documented previous exposure to the simulator, airway management techniques and devices, and participants’ subjective opinions on the instruction received.
Results: Eighty-two participants were enrolled into two groups of 41. Groups were comparable in terms of previous exposure and experience, as well as in pre-training scores. Both groups showed significant improvement in post-training scores. However, subjects receiving simulator training achieved significantly higher test scores in the MCQ (median 43 out of 50, interquartile range (IQR) 42–45, versus 41 out of 50, IQR 39–43); and OSCE assessment station 3 (median 15 out of 15, IQR 13–15, versus 14 and 12–15), and OSCE assessement station 4 (median 13 out of 15, IQR 12–14, versus 12 and 10–13). The simulator group showed greater participant satisfaction (95% vs. 34%).
Conclusion: There was improved immediate retention of knowledge and performance of airway management skills using the simulator. Participant satisfaction was much better in the simulator group. The importance of psychomotor reinforcement should be borne in mind when designing simulation courses.