Changing the view: impact of simulation-based mastery learning in pediatric tracheal intubation with videolaryngoscopy
Objective: To determine the effect of a training program using simulation-based mastery learning on the performance of residents in pediatric intubations with videolaryngoscopy. Method: Retrospective cohort study carried out in a tertiary pediatric hospital between July 2016 and June 2018 evaluating...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-01-01
|
| Series: | Jornal de Pediatria |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S002175571930590X |
| _version_ | 1828279195020558336 |
|---|---|
| author | Thomaz Bittencourt Couto Amélia G. Reis Sylvia C.L. Farhat Vitor E.L. Carvalho Claudio Schvartsman |
| author_facet | Thomaz Bittencourt Couto Amélia G. Reis Sylvia C.L. Farhat Vitor E.L. Carvalho Claudio Schvartsman |
| author_sort | Thomaz Bittencourt Couto |
| collection | DOAJ |
| description | Objective: To determine the effect of a training program using simulation-based mastery learning on the performance of residents in pediatric intubations with videolaryngoscopy. Method: Retrospective cohort study carried out in a tertiary pediatric hospital between July 2016 and June 2018 evaluating a database that included the performance of residents before and after training, as well as the outcome of tracheal intubations. A total of 59 pediatric residents were evaluated in the pre-training with a skills’ checklist in the scenario with an intubation simulator; subsequently, they were trained individually using a simulator and deliberate practice in the department itself. After training, the residents were expected to have a minimum passing grade (90/100) in a simulated scenario. The success of the first attempted intubation, use of videolaryngoscopy, and complications in patients older than 1 year of age during the study period were also recorded in clinical practice. Results: Before training, the mean grade was 77.5/100 (SD 15.2), with only 23.7% (14/59) of residents reaching the minimum passing grade of 90/100. After training, 100% of the residents reached the grade, with an average of 94.9/100 (SD 3.2), p < 0.01, with only 5.1% (3/59) needing more practice time than that initially allocated. The success rate in the first attempt at intubation in the emergency department with videolaryngoscopy was 77.8% (21/27). The rate of adverse events associated with intubations was 26% (7/27), representing a serious event. Conclusions: Simulation-based mastery learning increased residents’ skills related to intubation and allowed safe tracheal intubations with video laryngoscopy. |
| first_indexed | 2024-04-13T07:40:05Z |
| format | Article |
| id | doaj.art-57521d9bcab0405884d24a97fef428dc |
| institution | Directory Open Access Journal |
| issn | 0021-7557 |
| language | English |
| last_indexed | 2024-04-13T07:40:05Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Jornal de Pediatria |
| spelling | doaj.art-57521d9bcab0405884d24a97fef428dc2022-12-22T02:55:55ZengElsevierJornal de Pediatria0021-75572021-01-019713036Changing the view: impact of simulation-based mastery learning in pediatric tracheal intubation with videolaryngoscopyThomaz Bittencourt Couto0Amélia G. Reis1Sylvia C.L. Farhat2Vitor E.L. Carvalho3Claudio Schvartsman4Corresponding author.; Universidade de São Paulo, Faculdade de Medicina, Instituto da Criança, Hospital das Clínicas, São Paulo, SP, BrazilUniversidade de São Paulo, Faculdade de Medicina, Instituto da Criança, Hospital das Clínicas, São Paulo, SP, BrazilUniversidade de São Paulo, Faculdade de Medicina, Instituto da Criança, Hospital das Clínicas, São Paulo, SP, BrazilUniversidade de São Paulo, Faculdade de Medicina, Instituto da Criança, Hospital das Clínicas, São Paulo, SP, BrazilUniversidade de São Paulo, Faculdade de Medicina, Instituto da Criança, Hospital das Clínicas, São Paulo, SP, BrazilObjective: To determine the effect of a training program using simulation-based mastery learning on the performance of residents in pediatric intubations with videolaryngoscopy. Method: Retrospective cohort study carried out in a tertiary pediatric hospital between July 2016 and June 2018 evaluating a database that included the performance of residents before and after training, as well as the outcome of tracheal intubations. A total of 59 pediatric residents were evaluated in the pre-training with a skills’ checklist in the scenario with an intubation simulator; subsequently, they were trained individually using a simulator and deliberate practice in the department itself. After training, the residents were expected to have a minimum passing grade (90/100) in a simulated scenario. The success of the first attempted intubation, use of videolaryngoscopy, and complications in patients older than 1 year of age during the study period were also recorded in clinical practice. Results: Before training, the mean grade was 77.5/100 (SD 15.2), with only 23.7% (14/59) of residents reaching the minimum passing grade of 90/100. After training, 100% of the residents reached the grade, with an average of 94.9/100 (SD 3.2), p < 0.01, with only 5.1% (3/59) needing more practice time than that initially allocated. The success rate in the first attempt at intubation in the emergency department with videolaryngoscopy was 77.8% (21/27). The rate of adverse events associated with intubations was 26% (7/27), representing a serious event. Conclusions: Simulation-based mastery learning increased residents’ skills related to intubation and allowed safe tracheal intubations with video laryngoscopy.http://www.sciencedirect.com/science/article/pii/S002175571930590XSimulation trainingIntratracheal intubationEmergency medicineLaryngoscopyPediatrics |
| spellingShingle | Thomaz Bittencourt Couto Amélia G. Reis Sylvia C.L. Farhat Vitor E.L. Carvalho Claudio Schvartsman Changing the view: impact of simulation-based mastery learning in pediatric tracheal intubation with videolaryngoscopy Jornal de Pediatria Simulation training Intratracheal intubation Emergency medicine Laryngoscopy Pediatrics |
| title | Changing the view: impact of simulation-based mastery learning in pediatric tracheal intubation with videolaryngoscopy |
| title_full | Changing the view: impact of simulation-based mastery learning in pediatric tracheal intubation with videolaryngoscopy |
| title_fullStr | Changing the view: impact of simulation-based mastery learning in pediatric tracheal intubation with videolaryngoscopy |
| title_full_unstemmed | Changing the view: impact of simulation-based mastery learning in pediatric tracheal intubation with videolaryngoscopy |
| title_short | Changing the view: impact of simulation-based mastery learning in pediatric tracheal intubation with videolaryngoscopy |
| title_sort | changing the view impact of simulation based mastery learning in pediatric tracheal intubation with videolaryngoscopy |
| topic | Simulation training Intratracheal intubation Emergency medicine Laryngoscopy Pediatrics |
| url | http://www.sciencedirect.com/science/article/pii/S002175571930590X |
| work_keys_str_mv | AT thomazbittencourtcouto changingtheviewimpactofsimulationbasedmasterylearninginpediatrictrachealintubationwithvideolaryngoscopy AT ameliagreis changingtheviewimpactofsimulationbasedmasterylearninginpediatrictrachealintubationwithvideolaryngoscopy AT sylviaclfarhat changingtheviewimpactofsimulationbasedmasterylearninginpediatrictrachealintubationwithvideolaryngoscopy AT vitorelcarvalho changingtheviewimpactofsimulationbasedmasterylearninginpediatrictrachealintubationwithvideolaryngoscopy AT claudioschvartsman changingtheviewimpactofsimulationbasedmasterylearninginpediatrictrachealintubationwithvideolaryngoscopy |