Simulation-Based Mastery Learning of Bronchoscopy-Guided Percutaneous Dilatational Tracheostomy: Competency Acquisition and Skills Transfer to a Cadaveric Model. Issue 3 (June 2021)

• Record Type: Journal Article
• Authors: Kattan, Eduardo; De la Fuente, Rene; Putz, Francisca; Vera, Magdalena; Corvetto, Marcia; Inzunza, Oscar; Achurra, Pablo; Inzunza, Martin; Munoz-Gama, Jorge; Sepulveda, Marcos; Galvez, Victor; Pavez, Nicolas; Retamal, Jaime; Bravo, Sebastian
• Is Part Of: Simulation in healthcare. Volume 16:Issue 3(2021)
• Publication Date: 2021-06
• Subjects: Tracheostomy -- simulation training -- medical education -- critical care -- airway management; Simulated patients -- Periodicals; 362.1
• DOI: 10.1097/SIH.0000000000000491
• Languages: English
• ISSNs: 1559-2332

Abstract

Abstract : Introduction: Although simulation-based training has demonstrated improvement of procedural skills and clinical outcomes in different procedures, there are no published training protocols for bronchoscopy-guided percutaneous dilatational tracheostomy (BG-PDT). The objective of this study was to assess the acquisition of BG-PDT procedural competency with a simulation-based mastery learning training program, and skills transfer into cadaveric models. Methods: Using a prospective interventional design, 8 trainees naive to the procedure were trained in a simulation-based mastery learning BG-PDT program. Students were assessed using a multimodal approach, including blind global rating scale (GRS) scores of video-recorded executions, total procedural time, and hand-motion tracking–derived parameters. The BG-PDT mastery was defined as proficient tracheostomy (successful procedural performance, with less than 3 puncture attempts, and no complications) with GRS scores higher than 21 points (of 25). After mastery was achieved in the simulator, residents performed 1 BG-PDT execution in a cadaveric model. Results: Compared with baseline, in the final training session, residents presented a higher procedural proficiency (0% vs. 100%, P < 0.001), with higher GRS scores [8 (6–8) vs. 25 (24–25), P = 0.01] performed in less time [563 (408–600) vs. 246 (214–267), P = 0.01] and with higher movement economy. Procedural skills were further transferred to the cadaveric model. Conclusions: Residents successfully acquired BG-PDT procedural skills with a simulation-based mastery learning training program, and skills were effectively transferred to a cadaveric model. This easily replicable program is the first simulation-based BG-PDT training experience reported in the literature, enhancing safe competency acquisition, to further improve patient care. Abstract : Supplemental digital content is available in the text.