The emergency surgical airway: Bridging the gap from quality outcome to performance improvement through a novel simulation based curriculum

Abstract

Background: Emergency surgical airway is a low frequency, high risk clinical scenario. Implementing a simulation-based curriculum may bridge the gap in surgical training and address quality assurance/performance improvement (QAPI) needs.

Methods: We designed and implemented an Advanced Surgical Airway Curriculum (ASAC) modeled after proficiency-based training. General Surgery residents and student nurse anesthetists were enrolled. Evaluation consisted of cognitive tests, procedure checklists and questionnaire.

Results: In total, 78 participants successfully completed the ASAC. Trainees agreed that the curriculum provided the cognitive and psychomotor skills necessary to perform both an open and needle cricothyroidotomy.

Conclusions: In the age of increased patient safety concerns, QAPI initiatives can serve as a driver for simulation-based training curricula, with particular focus on individualized, active learning. This may be particularly useful in high risk, low frequency scenarios in which the traditional method of "See one, Do one, Teach one," is not feasible.

Keywords: Cricothyroidotomy; Emergency airway; Patient safety; Quality improvement; Simulation; Surgical education.