Prospective Randomized Controlled Trial of Video- Versus Recall-Assisted Reflection in Simulation-Based Teaching on Acquisition and Retention of Airway Skills Among Trainees Intubating Critically Ill Patients*. Issue 9 (September 2020)

• Record Type: Journal Article
• Authors: Prakash, Shivesh; Bihari, Shailesh; Laver, Russell; Chandran, Giresh; Kerr, Lachlan; Schuwirth, Lambert; Bersten, Andrew
• Is Part Of: Critical care medicine. Volume 48:Issue 9(2020)
• Publication Date: 2020-09
• Subjects: airway management -- feedback -- retention -- psychology -- simulation training -- teaching -- video recording; Critical care medicine -- Periodicals; Soins intensifs -- Périodiques; 616.028
• DOI: 10.1097/CCM.0000000000004448
• Languages: English
• ISSNs: 0090-3493

Abstract

Abstract : Objectives: Conventionally, simulation-based teaching involves reflection on recalled events (recall-assisted reflection). Instead of recall, video-assisted reflection may reduce recall bias and improve skills retention by contributing to visual memory. Here, we test the hypothesis that when compared with recall, video-assisted reflection results in higher acquisition and retention of skills involved in airway management among junior critical care doctors. Design: Randomized control trial. Participants were randomized 1:1 to video-assisted reflection or recall-assisted reflection group. Setting: University-affiliated tertiary care center. Subjects: Junior critical care doctors. Intervention: Video-assisted reflection. Measurements and Main Results: All participants underwent simulation-based teaching of technical and nontechnical airway skills involved in managing a critically ill patient. These skills were assessed before, post-workshop, and in the following fourth week, by two independent blinded assessors using a validated scoring tool. Quality of debrief was assessed using a validated questionnaire. Repeated-measures analysis of variance was used to assess time and group interaction. Forty doctors were randomized. At baseline, the groups had similar airway experience ( p = 0.34) and skill scores ( p = 0.97). There was a significant interaction between study groups and changes over time for total skill scores ( F [2, 37] = 4.06; p = 0.02). Although both the study groups had similar and significant improvement in total skills scores at the postworkshop assessment, the decline in total skills scores at delayed assessment ( F [1, 38] = 5.64; p = 0.02) was significantly more in the recall-assisted reflection group when compared with the video-assisted reflection group. This resulted in lower mean skill scores in the recall-assisted reflection group when compared with the video-assisted reflection group in the delayed assessment (89.45 [19.32] vs 110.10 [19.54]; p < 0.01). Better retention was predominantly in the nontechnical skills. The perceived quality of debrief was similar between the two groups. Conclusion: When compared with recall, video-assisted reflection resulted in similar improvement in airway skills, but better retention over time. Abstract : Supplemental Digital Content is available in the text.