Simulation Model for Tracheotomy Education for Primary Health-Care Providers

• Published in: Annals of otology, rhinology & laryngology Vol. 123; no. 1; pp. 11 - 18
• Main Authors: Dorton, LeighAnne H., Lintzenich, Catherine Rees, Evans, Adele K.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2014; SAGE PUBLICATIONS, INC
• Subjects: Clinical Competence; Emergency medical care; Health Knowledge, Attitudes, Practice; Hospitals; Hospitals, University; Humans; Manikins; Mortality; Physicians; Postoperative period; Primary Health Care; Prospective Studies; Surveys and Questionnaires; Tracheostomy - education; Tracheotomy - education; patient simulation; tracheotomy; medical education; tracheostomy
• ISSN: 0003-4894; 1943-572X
• DOI: 10.1177/0003489414521144

Objectives: We performed this study to evaluate the competency of health-care providers managing patients with tracheotomies, and assess the need for, and efficacy of, a multidisciplinary educational program incorporating patient simulation. Methods: The prospective observational study included 87 subjects who manage patients with tracheotomies within a tertiary-care hospital. The subjects completed self-assessment questionnaires and objective multiple-choice tests before and after attending a comprehensive educational course using patient simulation. The outcome measurements included pre-course and post-course questionnaire and test scores, as well as observational data collected during recorded patient simulation sessions. Results: Before the education and simulation, the subjects reported an average comfort level of 3.3 on a 5-point Likert scale across 10 categories in the questionnaire, which improved to 4.4 after the training (p < 0.0001). The subjects’ mean scores improved from 56% on the pre-course test to 91% on the post-course test (p < 0.0001). The specific deficiencies observed during patient simulation scenarios included unfamiliarity with different tracheotomy tube types, misunderstanding of speaking valve physiology, and delayed recognition and treatment of a plugged or dislodged tracheotomy tube. Conclusions: There is a significant need for improved tracheotomy education among primary health-care providers. Incorporating patient simulation into a comprehensive tracheotomy educational program was effective in improving provider confidence, increasing provider knowledge, and teaching the skills necessary for managing patients with a tracheotomy.