Advanced Airway Management Simulation Training in Medical Education

Kennedy, Cassie C.; Cannon, Eric; Warner, David O.; Cook, David A.

doi:10.1097/ccm.0b013e31829a721f

Cited by 190 publications

(130 citation statements)

References 60 publications

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“…3,15,17,18,45,46 Our finding that high physical realism simulators are weakly associated with improved outcomes when compared with low physical realism simulators differs from the results of other systematic reviews, suggesting that degree of realism has a negligible impact on learning outcomes. [47][48][49][50] These results suggest that the relationship between realism and learning is complex and nonlinear. In fact, the importance of realism likely depends on multiple factors, including the specific type or category of realism 22 (eg, physical versus conceptual versus emotional), learner type (eg, novice versus experienced), learning objectives (eg, cognitive versus technical), and educational context (eg, assessment versus educational).…”

Section: Integration With Previous Workmentioning

confidence: 91%

Technology-Enhanced Simulation and Pediatric Education: A Meta-analysis

et al. 2014

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BACKGROUND AND OBJECTIVE: Pediatrics has embraced technologyenhanced simulation (TES) as an educational modality, but its effectiveness for pediatric education remains unclear. The objective of this study was to describe the characteristics and evaluate the effectiveness of TES for pediatric education.METHODS: This review adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards. A systematic search of Medline, Embase, CINAHL, ERIC, Web of Science, Scopus, key journals, and previous review bibliographies through May 2011 and an updated Medline search through October 2013 were conducted. Original research articles in any language evaluating the use of TES for educating health care providers at any stage, where the content solely focuses on patients 18 years or younger, were selected. Reviewers working in duplicate abstracted information on learners, clinical topic, instructional design, study quality, and outcomes. We coded skills (simulated setting) separately for time and nontime measures and similarly classified patient care behaviors and patient effects. RESULTS:We identified 57 studies (3666 learners) using TES to teach pediatrics. Effect sizes (ESs) were pooled by using a random-effects model. Among studies comparing TES with no intervention, pooled ESs were large for outcomes of knowledge, nontime skills (eg, performance in simulated setting), behaviors with patients, and time to task completion (ES = 0.80-1.91). Studies comparing the use of high versus low physical realism simulators showed small to moderate effects favoring high physical realism (ES = 0.31-0.70).CONCLUSIONS: TES for pediatric education is associated with large ESs in comparison with no intervention. Future research should include comparative studies that identify optimal instructional methods and incorporate pediatric-specific issues into educational interventions.

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Section: Integration With Previous Workmentioning

confidence: 91%

Technology-Enhanced Simulation and Pediatric Education: A Meta-analysis

et al. 2014

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“…This enhanced competence afforded by simulation is especially important in skills development, an integral proficiency for students studying in health education. In particular, airways management education and hands-on training is essential [29] and changes attitudes and behavior for all health professionals [30]. This is especially true for trainee surgeons or paramedics studying high-priority invasive skills, such as direct laryngoscopy with foreign body removal in pre-emergency care [31], where students require confidence and experience to execute skills correctly.…”

Section: Literature Reviewmentioning

confidence: 99%

Mobile Mixed Reality for Experiential Learning and Simulation in Medical and Health Sciences Education

et al. 2018

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New accessible learning methods delivered through mobile mixed reality are becoming possible in education, shifting pedagogy from the use of two dimensional images and videos to facilitating learning via interactive mobile environments. This is especially important in medical and health education, where the required knowledge acquisition is typically much more experiential, self-directed, and hands-on than in many other disciplines. Presented are insights obtained from the implementation and testing of two mobile mixed reality interventions across two Australian higher education classrooms in medicine and health sciences, concentrating on student perceptions of mobile mixed reality for learning physiology and anatomy in a face-to-face medical and health science classroom and skills acquisition in airways management focusing on direct laryngoscopy with foreign body removal in a distance paramedic science classroom. This is unique because most studies focus on a single discipline, focusing on either skills or the learner experience and a single delivery modality rather than linking cross-discipline knowledge acquisition and the development of a student's tangible skills across multimodal classrooms. Outcomes are presented from post-intervention student interviews and discipline academic observation, which highlight improvements in learner motivation and skills, but also demonstrated pedagogical challenges to overcome with mobile mixed reality learning.

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“…Finally, the study was performed on mannequins. While simulation has been demonstrated to be an effective method for teaching airway skills [9], it is not clear how the performance of the upright position would translate to performance in actual patients. Live tissue in real patients is affected by gravity differently than mannequins.…”

Section: Limitationsmentioning

confidence: 99%

“…We believe this technique may be particularly beneficial to students learning to intubate for the first time or to providers who infrequently intubate. Simulation has been demonstrated to be an effective modality for airway education [9] and allows for clinical recreation that can be offered to multiple learners. The objective of this study was to measure the success of intubation of a simulated patient in an upright versus supine position by novice intubators after brief training.…”

Section: Introductionmentioning

confidence: 99%

Cross-over study of novice intubators performing endotracheal intubation in an upright versus supine position

et al. 2016

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. (2016). Cross-over study of novice intubators performing endotracheal intubation in an upright versus supine position. Internal and Emergency Medicine, 1-6. https://doi.org/10.1007/s11739-016-1481-z Novice Upright Intubation 2 Abstract: There are a number of potential physical advantages to performing orotracheal intubation in an upright position. The objective of this study was to measure the success of intubation of a simulated patient in an upright versus supine position by novice intubators after brief training. This was a cross-over design study in which learners (medical students, physician assistant students, and paramedic students) intubated mannequins in both a supine (head of the bed at 0 degrees) and upright (head of bed elevated at 45 degrees) position. The primary outcome of interest was successful intubation of the trachea. Secondary outcomes included log time to intubation, Cormack-Lehane view obtained, Percent of Glottic Opening score, provider assessment of difficulty, and overall provider satisfaction with the position. There were a total of 126 participants: 34 medical students, 84 physician assistant students, and 8 paramedic students. Successful tracheal intubation was achieved in 114 supine attempts (90.5%) and 123 upright attempts (97.6%; p = 0.283). Upright positioning was associated with significantly faster log time to intubation, higher likelihood of achieving Grade I Cormack-Lehane view, higher Percent of Glottic Opening score, lower perceived difficulty, and higher provider satisfaction. A subset of 74 participants had no previous intubation training or experience. For these providers, there was a non-significant trend toward improved intubation success with upright positioning vs supine positioning (98.6% vs. 87.8%, p = 0.283). For all secondary outcomes in this group, upright positioning significantly outperformed supine positioning.

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Advanced Airway Management Simulation Training in Medical Education

Abstract: Simulation-based airway management curriculum is superior to no intervention and nonsimulation intervention for important education outcomes. Further research is required to fine-tune optimal curricular design.

Cited by 190 publications

References 60 publications

Technology-Enhanced Simulation and Pediatric Education: A Meta-analysis

Technology-Enhanced Simulation and Pediatric Education: A Meta-analysis

Mobile Mixed Reality for Experiential Learning and Simulation in Medical and Health Sciences Education

Cross-over study of novice intubators performing endotracheal intubation in an upright versus supine position

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