Teaching Tracheostomy Tube Changes: Comparison of Operant Learning Versus Traditional Demonstration
Abstract Objective Tracheostomy tube change is a multistep skill that must be performed rapidly and precisely. Despite the critical importance of this skill, there is wide variation in teaching protocols. Methods An innovative operant conditioning teaching methodology was employed and compared to tr...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | OTO Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/oto2.93 |
| _version_ | 1797375300658528256 |
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| author | Elliot Schiff Anthony Ma Tracy Cheung Marc‐Mina Tawfik Ryan S. Ference Michael S. Weinstock I. Martin Levy Christina J. Yang |
| author_facet | Elliot Schiff Anthony Ma Tracy Cheung Marc‐Mina Tawfik Ryan S. Ference Michael S. Weinstock I. Martin Levy Christina J. Yang |
| author_sort | Elliot Schiff |
| collection | DOAJ |
| description | Abstract Objective Tracheostomy tube change is a multistep skill that must be performed rapidly and precisely. Despite the critical importance of this skill, there is wide variation in teaching protocols. Methods An innovative operant conditioning teaching methodology was employed and compared to traditional educational techniques. Medical student volunteers at a tertiary care academic institution (Albert Einstein College of Medicine) were recruited and randomly distributed into 2 groups: operant vs traditional (control). Following the educational session, each group was provided with practice time and then asked to perform 10 tracheostomy tube changes. Performance was recorded and scored by blinded raters using deidentified video recordings. Results The operant learning group (OLG) demonstrated greater accuracy in performing a tracheostomy tube change than the traditional demonstration group. Twelve of 13 operant learners performed the skill accurately each time compared to 3 of 13 in the traditional group (P = 0.002). The median lesson time was longer for the OLG (535 seconds) than for the traditional group, (200 seconds P < 0.001). The average time per tracheostomy change was not significantly different between the 2 groups (operant learners mean 7.1 seconds, traditional learners mean 7.5 seconds, P = 0.427). Discussion Although the operant conditioning methodology necessarily requires a greater time to teach, the results support this methodology over traditional learning modalities as it enhances accuracy in the acquired skill. Operant learning methodology is under consideration for other skills and education sessions in our program. Future steps include the application and adaptation of this education model to students and residents in other settings and fields. Implications for Practice Operant learning is effective for teaching multistep skills such as tracheostomy tube changes with decreased error rates. |
| first_indexed | 2024-03-08T19:22:16Z |
| format | Article |
| id | doaj.art-36d4b815c6b944168f8bc304c1cb82d7 |
| institution | Directory Open Access Journal |
| issn | 2473-974X |
| language | English |
| last_indexed | 2024-03-08T19:22:16Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | OTO Open |
| spelling | doaj.art-36d4b815c6b944168f8bc304c1cb82d72023-12-26T15:36:31ZengWileyOTO Open2473-974X2023-10-0174n/an/a10.1002/oto2.93Teaching Tracheostomy Tube Changes: Comparison of Operant Learning Versus Traditional DemonstrationElliot Schiff0Anthony Ma1Tracy Cheung2Marc‐Mina Tawfik3Ryan S. Ference4Michael S. Weinstock5I. Martin Levy6Christina J. Yang7Albert Einstein College of Medicine Bronx New York USADepartment of Emergency Medicine Mount Sinai Morningside and Mount Sinai West New York City New York USAAlbert Einstein College of Medicine Bronx New York USAAlbert Einstein College of Medicine Bronx New York USADepartment of Anesthesiology Weill Cornell Medicine New York City New York USADepartment of Surgery, Division of Otolaryngology Yale New Haven Children's Hospital New Haven Connecticut USAAlbert Einstein College of Medicine Bronx New York USAAlbert Einstein College of Medicine Bronx New York USAAbstract Objective Tracheostomy tube change is a multistep skill that must be performed rapidly and precisely. Despite the critical importance of this skill, there is wide variation in teaching protocols. Methods An innovative operant conditioning teaching methodology was employed and compared to traditional educational techniques. Medical student volunteers at a tertiary care academic institution (Albert Einstein College of Medicine) were recruited and randomly distributed into 2 groups: operant vs traditional (control). Following the educational session, each group was provided with practice time and then asked to perform 10 tracheostomy tube changes. Performance was recorded and scored by blinded raters using deidentified video recordings. Results The operant learning group (OLG) demonstrated greater accuracy in performing a tracheostomy tube change than the traditional demonstration group. Twelve of 13 operant learners performed the skill accurately each time compared to 3 of 13 in the traditional group (P = 0.002). The median lesson time was longer for the OLG (535 seconds) than for the traditional group, (200 seconds P < 0.001). The average time per tracheostomy change was not significantly different between the 2 groups (operant learners mean 7.1 seconds, traditional learners mean 7.5 seconds, P = 0.427). Discussion Although the operant conditioning methodology necessarily requires a greater time to teach, the results support this methodology over traditional learning modalities as it enhances accuracy in the acquired skill. Operant learning methodology is under consideration for other skills and education sessions in our program. Future steps include the application and adaptation of this education model to students and residents in other settings and fields. Implications for Practice Operant learning is effective for teaching multistep skills such as tracheostomy tube changes with decreased error rates.https://doi.org/10.1002/oto2.93medical educationPSQItracheostomytracheotomy |
| spellingShingle | Elliot Schiff Anthony Ma Tracy Cheung Marc‐Mina Tawfik Ryan S. Ference Michael S. Weinstock I. Martin Levy Christina J. Yang Teaching Tracheostomy Tube Changes: Comparison of Operant Learning Versus Traditional Demonstration OTO Open medical education PSQI tracheostomy tracheotomy |
| title | Teaching Tracheostomy Tube Changes: Comparison of Operant Learning Versus Traditional Demonstration |
| title_full | Teaching Tracheostomy Tube Changes: Comparison of Operant Learning Versus Traditional Demonstration |
| title_fullStr | Teaching Tracheostomy Tube Changes: Comparison of Operant Learning Versus Traditional Demonstration |
| title_full_unstemmed | Teaching Tracheostomy Tube Changes: Comparison of Operant Learning Versus Traditional Demonstration |
| title_short | Teaching Tracheostomy Tube Changes: Comparison of Operant Learning Versus Traditional Demonstration |
| title_sort | teaching tracheostomy tube changes comparison of operant learning versus traditional demonstration |
| topic | medical education PSQI tracheostomy tracheotomy |
| url | https://doi.org/10.1002/oto2.93 |
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