Just-In-Time Rapid Cycle Deliberate Practice Simulation Intubation Training Among Novice Pediatric Anesthesia Trainees: A Randomized Control Study
- Conditions
- Anesthesia
- Interventions
- Other: Simulation Airway Coaching
- Registration Number
- NCT04472195
- Lead Sponsor
- Boston Children's Hospital
- Brief Summary
The purpose of this study is to assess the impact of Just-In-Time (J-I-T) Rapid Cycle Deliberate Practice (RCDP) Simulation Training on laryngoscopy competency among novice pediatric anesthesia trainees.
- Detailed Description
Multiple intubation attempts in infants are potentially more harmful than previously suspected. Emerging literature suggests each additional attempt past an initial laryngoscopy correlates with a two-fold increase in complications. Therefore, striving to secure the neonate/infant airway on the first attempt is optimal for infant safety. Novice trainees lack experience with airway management in small children. To promote a patient safety culture among the multitude of rotating trainees at Boston Children's Hospital the investigators would like to augment airway management with Rapid Cycle Deliberate Practice Simulation Training (RCDP). Rotating trainees at BCH main campus will be prospectively randomized to experimental vs. control group for intubation of neonates and infants less than or equal to 12 months of age. Infants with known congenital heart disease, known or suspected difficult airways, or COVID-19 positive status will be excluded from the study. The experimental group will review a pre-induction airway management plan for their upcoming case and rapid cycle deliberate practice (RCDP) on a simulator with an anesthesia attending coaching on technique prior to real patient intubation. Primary outcome measure will be first attempt success rate. Other outcome measures include: complication rates, a team developed Likert scale that investigates intubation competency and utility of JIT/RCDP training, and NASA-TLX (a validated cognitive task load index).
The study would be the first to directly determine how and if simulation-based pediatric airway interventions are immediately transferable to actual clinical environments in pediatric anesthesiology. Such a study may change how training programs prepare novices for "game time" performance and become a new standard of care in airway management training.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 182
- Anesthesia Residents
- SRNA
- Pediatric Anesthesia Fellows
- Medical Students
- Off-Service Rotators
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Experimental Simulation Airway Coaching The experimental group will review a pre-induction airway management plan for their upcoming case and undergo a scripted 10-minute RCDP session with an airway coach within 1 hour of patient intubation. The intubation approach (DL vs. video assisted DL) will be chosen by the primary case attending and communicated to the airway coach to simulate the planned laryngoscopy attempt. The experimental group will then proceed with their scheduled case with a member of the research team observing the laryngoscopy attempt(s) to capture data.
- Primary Outcome Measures
Name Time Method 1st attempt success rate Through study completion, anticipated 12-15 months Trainee first attempt success rate will be observed by the study team
- Secondary Outcome Measures
Name Time Method Evaluation of utility of JIT/RCDP Through study completion, anticipated 12-15 months Trainees will fill out Likert Questions developed in conjunction with Boston Children's Survey Methodologist
Complication rate Through study completion, anticipated 12-15 months Trainee complication rates of laryngoscopy will be observed by the study team
Self evaluation of neonate/infant laryngoscopy Through study completion, anticipated 12-15 months Trainees will fill out Likert questions developed in conjunction with Boston Children's Survey Methodologist
Cognitive Load in intubating patient Through study completion, anticipated 12-15 months NASA-TLX will be administered to trainees to evaluate cognitive task load
Trial Locations
- Locations (1)
Boston Children's Hopsital
🇺🇸Boston, Massachusetts, United States