1 NEUROSCIENCE, BAYLOR UNIVERSITY, WACO, TX, USA; 2 ACADEMIC RESEARCH INTEGRATION, SCOTT & WHITE HEALTHCARE/TEXAS A&M HEALTH SCIENCES CENTER COLLEGE OF MEDICINE, TEMPLE, TX, USA; and 3 ANESTHESIOLOGY, SCOTT & WHITE HEALTHCARE/TEXAS A&M HEALTH SCIENCES CENTER COLLEGE OF MEDICINE, TEMPLE, TX, USA; and 4 MEDICAL STUDENT, SCOTT & WHITE HEALTHCARE/TEXAS A&M HEALTH SCIENCES CENTER COLLEGE OF MEDICINE, TEMPLE, TX, USA; and 5 MEDICAL STUDENT, TEXAS A&M HEALTH SCIENCE CENTER COLLEGE OF MEDICINE, TEMPLE, TX, USA.
Introduction/Background: Competence in airway management is a skill needed to safely administer anesthesia. Difficult or failed airway management is a major factor in anesthesia-related morbidity and mortality.1 Medical students have minimal opportunity to acquire airway management skills during medical school, particularly in the preclinical years. The Gillespie Anesthesiology Student Society (GASS) developed an educational workshop to expose medical students to airway management skills and the field of anesthesia that consisted of a pre-assessment survey, interactive hands-on skills stations and a post assessment survey.
Methods: To assess the workshop’s effectiveness, an optional survey was administered to the learners in attendance. The survey consisted of 25 questions that measured the student’s self-perceived competency of airway management, their understanding of the field of anesthesiology and their desire to pursue anesthesiology as a specialty. This survey was given before and after the interactive airway workshop. The workshop was organized into three 1.5 hour sessions, with two sessions consisting of first and second year medical students and one session consisting of third year medical students. An attending anesthesiologist and an anesthesia resident facilitated skills stations of fiberoptic bronchoscopy, direct laryngoscopy, video-assisted laryngoscopy, placement of a laryngeal mask airway, bag valve mask ventilation, overview of anesthesia workstation and overview of ultrasound guided regional anesthesia using a live model. Fifteen medical students attended the airway workshop and completed the optional pre and post survey that employed a five point Likert scale. Five subjects were third year medical students, four were second year medical students and six were first year medical students.With the exception of one item in the ‘interest in anesthesiology career questionnaire, paired T-test analysis indicates statistically significant improvement in all questions by the entire cohort. When separated from the third year medical students, the first and second year medical students had more significant improvements than did third year medical students as shown in the table.
Results: Conclusion: Multiple studies have demonstrated that simulation training is an effective tool in teaching airway management skills.2 The preclinical students showed significant improvements in their self-perceived competence of airway management while the third year students showed no major improvements. None of the cohort indicated pronounced improvement in their interest for anesthesia as a career. One weakness of the study was that the outcome measures were self-assessed. Future studies could utilize objective measures using trained observers to judge airway management techniques or more sophisticated simulators that are able to accurately record tidal volumes during mask ventilation. Third year medical students who already have basic airway management skills could potentially benefit more from participating in a crisis resource management workshop.
References: 1. Caplan R.A., Benumof J.L., Berry F.A., et al. Practice guidelines for management of the difficult airway. Anesthesiology. 2003;98:1269-1277.22. Lucisano, K.E., Talbot, L.A.
2. Simulation Training for Advanced Airway Management for Anesthesia and Other Healthcare Providers: A Systematic Review. AANA Journal. 2012. 80:25-31.