Complex procedural skills are retained for a minimum of 1 yr after a single high-fidelity simulation training session

• Published in: British journal of anaesthesia : BJA Vol. 107; no. 4; pp. 533 - 539
• Main Authors: Boet, S., Borges, B.C.R., Naik, V.N., Siu, L.W., Riem, N., Chandra, D., Bould, M.D., Joo, H.S.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-10-2011; Oxford University Press
• Subjects: airway management; Airway Management - methods; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthesiology - education; Biological and medical sciences; Clinical Competence; Cricoid Cartilage - surgery; Emergency Medical Services - methods; Humans; Intraoperative Complications - therapy; Learning; Manikins; Medical sciences; Observer Variation; patient simulation; retention; Sample Size; Single-Blind Method; Thyroidectomy; Time Factors; patient simulation; airway management; retention; Human; Clinical management; Simulation; Anesthesia
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/aer160

Simulation has been shown to be effective in teaching complex emergency procedural skills. However, the retention of these skills for a period of up to 1 yr has not been studied. We aimed to investigate the 6 month and 1 yr retention of the complex procedural skill of cricothyroidotomy in attending anaesthetists using a high-fidelity-simulated cannot intubate, cannot ventilate (CICV) scenario.
Thirty-eight attending anaesthetists participated individually in a high-fidelity-simulated CICV scenario (pretest) that required a cricothyroidotomy for definitive airway management. Immediately after a debriefing and structured teaching session on cricothyroidotomy insertion, subjects managed a second identical CICV scenario (post-test). Each anaesthetist was randomized to either a ‘6 month retention’ or a ‘12 month retention’ group. No further teaching occurred. At their respective retention times, each anaesthetist managed a third identical CICV scenario (retention post-test). Two blinded experts independently rated videos of all performances in a random order, using a specific checklist (CL) score, a global-rating scale (GRS) score, and procedural time (PT).
Subjects from both groups improved on their cricothyroidotomy skill performances from pretest to immediate post-test and from pretest to retention post-test, irrespective of the retention interval; CL mean (sd) 8.00 (2.39) vs 8.88 (1.53), P=0.49; GRS 28.00 (7.80) vs 31.25 (5.31), P=0.25; PT 102.83 (63.81) s vs 106.88 (36.68) s, P=0.73.
After a single simulation training session, improvements in cricothyroidotomy skills are retained for at least 1 yr. These findings suggest that high-fidelity simulation training, along with practice and feedback, can be used to maintain complex procedural skills for at least 1 yr.