P23 Delivering a multicentre paediatric and neonatal airway simulation programme. (November 2018)

• Record Type: Journal Article
• Authors: Jamieson, Katharine; Driscoll, Jacqueline; Wicker, James; John, Sini; Dimmock, Val; Casser, Carmel; Mulchandani, Haresh
• Is Part Of: BMJ simulation & technology enhanced learning. Volume 4(2018)Supplement 2
• Page Start: A61
• Page End: A61
• Publication Date: 2018-11
• Subjects: Medicine -- Simulation methods -- Periodicals; Medical innovations -- Periodicals; 610.113
• DOI: 10.1136/bmjstel-2018-aspihconf.115
• Languages: English
• ISSNs: 2056-6697

Abstract

Abstract : Introduction: There is growing evidence that simulation-based training (SBT) is effective as an educational intervention with translation of learning to the workplace. 1 Successful management of difficult paediatric or neonatal airways depends on dynamic and effective team working, pooling of skills between specialities, and attention to and appreciation of the role human factors plays in the outcome of the endeavour. 2 In addition to the challenges of forming an effective, cohesive team, differences in the clinical approach and management between specialities can pose additional difficulties. Development of a simulation course focusing on both non-technical and technical skills, aimed at inter-disciplinary healthcare professionals involved in such management would therefore seem beneficial. Methods: With the support of University College London Partners (UCLP), an experienced cross-site simulation faculty (neonatal, paediatric, emergency, anaesthetic health professionals) delivered the DAMPN (Developing an approach to Airway Management in Paediatrics and Neonates) simulation course to multi-disciplinary participants. The course utilised a blended learning approach, incorporating interactive discussions, team-working exercises, clinical workshops and simulations to explore and practice the technical skills necessary for safe airway management, as well as behaviours vital for effective team performance. Pre- and post-course questionnaires utilising Likert-type scales (1–5), were completed anonymously by course participants from hospitals in East London and pertained to 8 technical factors and 4 human factors as well as overall satisfaction with the course. A novel qualitative methodology via responses to emotive picture stimuli to capture participants anxieties, fears and hopes was used as a means to prompt open discussion on these issues. Results: Self reported confidence in use of ALL the core technical skills deemed essential for safe airway management improved with statistical significance from pre mean 3.05 (CI 2.92 to 3.17) to post mean 4.13 (CI 4.04 to 4.21). Improvement in all non-technical/human factor skills was also demonstrated, pre mean 3.35 (CI 3.19 to 3.51) to post mean 4.20 (CI 4.09 to 4.32). The course was considered to be beneficial and enjoyable by all participants with a mean Likehart of 4.61. Conclusions and recommendations: Paediatric and neonatal airway management is a situation that provokes anxiety for many health professionals from different specialities irrespective of seniority. Demonstrable improvement in pre-post course confidence assessment and overwhelmingly positive course evaluations (quantitative and qualitative) suggest a critical and ongoing role for such an inter-disciplinary course in promoting technical and non-technical skills involved in the safe management of paediatric and neonatal airways. References: Boet S, Bould MD, Fung L, et al. Transfer of learning and patient outcome in simulated crisis resource management: A systematic review. Can J Anaesth2014;61:571–582. Reber A. The paediatric upper airway: anaesthetic aspects and conclusions. Curr Opin Anaesthesiol2004;17(3):217–21.