Journal of Emergency Practice and Trauma

The effect of teacher-made simulation moulage on learning cricothyrotomy skills in emergency medicine physicians

Document Type : Original Article

Authors

Hamid Reza Moretza Bagi 1
Amir Ghaffarzad 2
Peyman Fathipour 2
Reza Yazdani 3
Zhila Khamnian 4
Sama Rahnemayan 5

1 Emergency Medicine Research Team, Tabriz University of Medical Science, Tabriz, Iran

2 Department of Emergency Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

3 Trauma and Medical Emergencies Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

4 Department of Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

5 Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran

https://doi.org/10.34172/jept.2021.10
Abstract
Objective: Nowadays, simulation of clinical environment in medical education system (simulation-based learning) has led to a huge revolution in the quality of education and has increased the safety of educators and patients. In this study, we investigated the effect of teacher-made neck and lung simulators in teaching cricothyrotomy skills for emergency medicine residents.
Methods: In this pre-post test study, all faculty member of emergency medicine of Tabriz University of medical sciences specialty were invited to participate. After holding an educational and training session for assistants on a teacher-made moulage, all emergency medicine residents performed a tracheostomy on the commercial moulages of the skill lab unit for the second time and their scores were recorded.
Results: In this study, 23 emergency medicine residents participated. The mean ± standard deviation of age was 35.91 ± 3.57 years. There was a significant difference between the mean duration of cricothyrotomy before and after the training (P value = 0.006). There was also a significant difference between the mean scores obtained by residents in the pre- and post-training evaluation (P value < 0.001).
Conclusion: Findings showed that the moulages constructed by teachers not only can be effective in improving the cricothyrotomy skills in emergency medicine residents but also can reduce the likelihood of failure in performing cricothyrotomy.

Keywords

Cricothyrotomy
Difficult airway
Teacher made models
Skills laboratory
Emergency medicine
Subjects
1. Soleimanpour H, Shams Vahdati S, Mahmoodpoor A, Rahimi Panahi J, Afhami MR, Pouraghaei M, et al. Modifiedcricothyroidotomy in skill laboratory. J Cardiovasc Thorac Res 2012; 4(3): 73-6. doi: 10.5681/jcvtr.2012.018.
2. Wang HE, Yealy DM. How many attempts are required to accomplish out-of-hospital endotracheal intubation? Acad Emerg Med 2006; 13(4): 372-7. doi: 10.1197/j.aem.2005.11.001.
3. Wang HE, Kupas DF, Greenwood MJ, Pinchalk ME, Mullins T, Gluckman W, et al. An algorithmic approach
to prehospital airway management. Prehosp Emerg Care 2005; 9(2): 145-55. doi: 10.1080/10903120590924618.
4. Kneebone R. Simulation in surgical training: educational issues and practical implications. Med Educ 2003; 37(3): 267-77. doi: 10.1046/j.1365-2923.2003.01440.x.
5. Dent JA. Current trends and future implications in the developing role of clinical skills centres. Med Teach 2001;23(5): 483-9. doi: 10.1080/01421590120075724.
6. Kozu T. Medical education in Japan. Acad Med 2006; 81(12): 1069-75. doi: 10.1097/01.ACM.0000246682.45610.dd.
7. Hao J, Estrada J, Tropez-Sims S. The clinical skills laboratory: a cost-effective venue for teaching clinical skills to third-year medical students. Acad Med 2002; 77(2): 152. doi: 10.1097/00001888-200202000-00012.
8. Kneebone R, Nestel D. Learning clinical skills-the place of simulation and feedback. Clin Teach 2005; 2(2): 86-90. doi:10.1111/j.1743-498X.2005.00042.x.
9. Weller J, Robinson B, Larsen P, Caldwell C. Simulationbased training to improve acute care skills in medical undergraduates. N Z Med J 2004; 117(1204): U1119.
10. Paparella SF, Mariani BA, Layton K, Carpenter AM. Patient safety simulation: learning about safety never seemed more fun. J Nurses Staff Dev 2004; 20(6): 247-52. doi: 10.1097/00124645-200411000-00001.
11. Galvagno SM Jr, Nahmias JT, Young DA. Advanced trauma life support® update 2019: management and applications for adults and special populations. Anesthesiol Clin 2019;37(1): 13-32. doi: 10.1016/j.anclin.2018.09.009.
12. Burkey B, Esclamado R, Morganroth M. The role of cricothyroidotomy in airway management. Clin Chest Med1991; 12(3): 561-71.
13. Fortune JB, Judkins DG, Scanzaroli D, McLeod KB, Johnson SB. Efficacy of prehospital surgical cricothyrotomy in trauma patients. J Trauma 1997; 42(5): 832-6. doi:10.1097/00005373-199705000-00013.
14. Wang J, Lin YI, Hou SY. A data mining approach for training evaluation in simulation-based training. ComputInd Eng 2015; 80: 171-80. doi: 10.1016/j.cie.2014.12.008.
15. Buonopane CE, Pasta V, Sottile D, Del Vecchio L, Maturo A, Merola R, et al. Cricothyrotomy performed with the Melker™ set or the QuickTrach™ kit: procedure times, learning curves and operators’ preference. G Chir 2014;35(7-8): 165-70.
16. Schaumann N, Lorenz V, Schellongowski P, Staudinger T, Locker GJ, Burgmann H, et al. Evaluation of Seldinger technique emergency cricothyroidotomy versus standard surgical cricothyroidotomy in 200 cadavers. Anesthesiology 2005; 102(1): 7-11. doi: 10.1097/00000542-200501000-00005.
17. Metterlein T, Frommer M, Ginzkey C, Becher J, Schuster F, Roewer N, et al. A randomized trial comparing two cuffed emergency cricothyrotomy devices using a wire-guided and a catheter-over-needle technique. J Emerg Med 2011; 41(3):326-32. doi: 10.1016/j.jemermed.2010.04.008.
18. Aneeshkumar MK, Jones TM, Birchall MA. A new indicator-guided percutaneous emergency cricothyrotomy device: in vivo study in man. Eur Arch Otorhinolaryngol 2009; 266(1): 105-9. doi: 10.1007/s00405-008-0698-5.
19. Shetty K, Nayyar V, Stachowski E, Byth K. Training for cricothyroidotomy. Anaesth Intensive Care 2013; 41(5):623-30. doi: 10.1177/0310057x1304100508.
20. Mandell D, Orebaugh SL. A porcine model for learning ultrasound anatomy of the larynx and ultrasound-guided cricothyrotomy. Simul Healthc 2019; 14(5): 343-7. doi:10.1097/sih.0000000000000364.
21. Aho JM, Thiels CA, AlJamal YN, Ruparel RK, Rowse PG, Heller SF, et al. Every surgical resident should know how to perform a cricothyrotomy: an inexpensive cricothyrotomy task trainer for teaching and assessing surgical trainees. J Surg Educ 2015; 72(4): 658-61. doi: 10.1016/j.jsurg.2014.12.012.
22. Hughes KE, Biffar D, Ahanonu EO, Cahir TM, Hamilton A, Sakles JC. Evaluation of an innovative bleeding cricothyrotomy model. Cureus 2018; 10(9): e3327. doi:10.7759/cureus.3327.
23. McCarthy MC, Ranzinger MR, Nolan DJ, Lambert CS, Castillo MH. Accuracy of cricothyroidotomy performed in canine and human cadaver models during surgical skills training. J Am Coll Surg 2002; 195(5): 627-9. doi: 10.1016/s1072-7515(02)01337-6.
24. Friedman Z, You-Ten KE, Bould MD, Naik V. Teaching lifesaving procedures: the impact of model fidelity on acquisition and transfer of cricothyrotomy skills to performance on cadavers. Anesth Analg 2008; 107(5): 1663-9. doi: 10.1213/ane.0b013e3181841efe.
25. Eaton BD, Messent DO, Haywood IR. Animal cadaveric models for advanced trauma life support training. Ann R Coll Surg Engl 1990; 72(2): 135-9.
26. Sergeev I, Lipsky AM, Ganor O, Lending G, Abebe-Campino G, Morose A, et al. Training modalities and self-confidence building in performance of life-saving procedures. Mil Med 2012; 177(8): 901-6. doi: 10.7205/milmed-d-12-00018.
27. Custalow CB, Kline JA, Marx JA, Baylor MR. Emergency department resuscitative procedures: animal laboratory training improves procedural competency and speed. Acad Emerg Med 2002; 9(6): 575-86. doi: 10.1111/j.1553-2712.2002.tb02294.x.
28. Cho J, Kang GH, Kim EC, Oh YM, Choi HJ, Im TH, et al. Comparison of manikin versus porcine models in cricothyrotomy procedure training. Emerg Med J 2008; 25(11): 732-4. doi: 10.1136/emj.2008.059014.
Journal of Emergency Practice and Trauma
Volume 8, Issue 1
January 2022
Pages 3-7

  • Receive Date 13 December 2020
  • Revise Date 11 March 2021
  • Accept Date 31 March 2021

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