815 Australian Surgery Trainee Education for Contemporary Airway Management of OSA: A Pilot Randomised Controlled Study

Abstract

Introduction In Australia, ASOHNS delivers no formal curriculum for training of OHNS, or levels of competency required, to assess and treat complex OSA patients. Australian OHNS trainee confidence, knowledge and exposure to complex multi-level OSA surgery is lacking. Lack of exposure to sufficient complex OSA surgery case load has been identified as a major weakness in training within a recently published international survey. This study was a randomized clinical trial evaluating the effect of Australian OHNS trainee exposure to education materials compared with no exposure, on Sleep Surgery specific examination performance (multiple choice and short written answer). Methods 70 accredited and 45 unaccredited OHNS trainees were invited to participate in this trial. Participants were randomly assigned to Sleep Surgery educational material exposure or no exposure to those materials. Those randomized to the exposure group were provided educational material and were given 2 weeks exposure time prior to the exam. Each participant then complete an online examin, consisting of 40 multiple choice questions and 1 short answer question (marked by a field expert). Differences between exposure and control group means were tested using independent t-tests. Results 24 trainees were allocated to exposure and 22 to control. 33 participants attempted the examination. The were no significant differences between groups in the multiple choice (mean difference 1.3 ± 1.6 [3.3%], p=0.41) or written exam test scores (mean difference 1.8 ± 1.2 [9.0%], p=0.14). Accredited trainees performed better in the written exam (mean difference 2.6 ± 1.1 [13.0%], p=0.03). The mean test score in a separate exploratory group of 2 sleep fellowship trained OHNS was considerably higher in both exams. Conclusion This study suggests that exposure to formal education material may improve understanding of sleep surgery. Accredited trainees performed better than unaccredited trainees but the difference was small. Poor test performance in both groups may indicate further formal sleep surgery teaching is required in the ASOHNS training curriculum. Further research is required to identify the best ways possible to educate OHNS trainees in the complex and nuanced decision making required for OSA patients. Support (if any) Illawarra Health and Medical Research Institute Grant 2019.