A multidisciplinary international collaborative implementing low cost, high fidelity 3D printed airway models to enhance Ethiopian anesthesia resident emergency cricothyroidotomy skills. (November 2018)

• Record Type: Journal Article
• Authors: Gauger, Virginia T.; Rooney, Deborah; Kovatch, Kevin J.; Richey, Lauren; Powell, Allison; Berhe, Hailesllassie; Zopf, David A.
• Is Part Of: International journal of pediatric otorhinolaryngology. Volume 114(2018:Nov.)
• Page Start: 124
• Page End: 128
• Publication Date: 2018-11
• Subjects: Global health -- Printing -- Three dimensional -- Anesthesiology -- Otolaryngology -- Emergencies -- Learning; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Oto-rhino-laryngologie -- Périodiques; Pédiatrie -- Périodiques; 618.9209751
• DOI: 10.1016/j.ijporl.2018.08.040
• Languages: English
• ISSNs: 0165-5876

Abstract

Abstract: Background: Similar to other sub-Saharan countries, Ethiopia suffers from a severe shortage of adequately trained health professionals. Academic partnerships can support sustainable training programs and build capacity for low-resource settings. 3D modeling and simulation-based training provide necessary tools, especially for rarely-encountered clinical situations, such as needle cricothyroidotomy. Methods: Departments of Anesthesiology, Otolaryngology, and Learning Health Sciences collaborated to develop a low-cost, high-fidelity simulator and Cricothryoidotomy Skills Maintenance Program (CSMP). Twelve anesthesia residents at St. Paul's Hospital Medical Millennium College in Addis Ababa, Ethiopia participated in CSMP. The program consisted of a didactic session with presentation and demonstration and an immersive CICO scenario. Program evaluation was performed using pre/post-training knowledge and 2 procedural performance assessments-the CSMP Global Rating Scale and the Checklist. With consent, performances were videotaped and rated independently by 3 University of Michigan faculty. Results: Improvements were identified in all areas, including residents' knowledge, measured by mean summed test scores (Mpre = 3.31, Mpost = 4.46, p = 0.003), time to perform cricothyroidotomy (Mpre = 96.64, Mpost = 72.82, p = 0.12), residents' performance quality, measured by overall mean Global ratings, (Mpre = 0.20; Mpost = 0.70) with improvements identified at the item-level, p = 0.001 with moderate-large effect sizes, and residents' ability to complete tasks, measured by mean Checklist ratings (Mpre = 0.51, Mpost = 0.90, with item-level improvements observed, p ≤ 0.01, with small-large effect sizes. Residents' self-reported confidence also improved (Mpre = 1.69, Mpost = 3.08, p = 0.001). Conclusion: Our work shows that cricothyroidotomy skills taught to anesthesia residents at SPHMMC with a 3D printed laryngotracheal model improves knowledge, skills, and confidence. The creation of a low-cost, high-fidelity simulator and a CSMP has the potential to impact patient care and safety world-wide.