Management of aerodigestive tract foreign bodies: innovative teaching concepts.
OBJECTIVE
We discuss a method to provide medical education in bronchoesophagology by using high-fidelity patient simulation manikins.


METHODS
A sophisticated, life-sized infant manikin with realistic anatomic, physiologic, and hemodynamic responses to interventions was programmed to simulate endobronchial foreign body lodgment by blocking ventilation of one lung and manifesting audible stridor, asymmetric chest wall motion, and decreased oxygen saturation.


RESULTS
Otolaryngology residents participated in simulation exercises incorporating the cognitive and technical skills necessary for successful airway endoscopy, including technical proficiency and teamwork, to learn to coordinate endoscopy and ventilation and manage laryngospasm. Rather than relying on instructor description, the participants responded directly to the manikin. This sense of realism stimulated participants to rehearse to improve provider performance and patient safety. Simulation provided an agenda determined by the needs of the learners, exploration without direct risk to patients, immediate feedback, and objective documentation.


CONCLUSIONS
Rapidly evolving medical simulation technologies support activated, effective adult learning; they will play an increasing role in medical education.
Deutsch
Ellen S
ES
Division of Pediatric Otolaryngology, Alfred I. duPont Hospital for Children, Wilmington, Delaware 19899, USA.
Dixit
Divya
D
Curry
Joseph
J
Malloy
Kelly
K
Christenson
Tom
T
Robinson
Barbara
B
Cognetti
David
D
D001999:Bronchoscopy; D004945:Esophagoscopy; D005547:Foreign Bodies / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007223:Infant; D007396:Internship and Residency; D007826:Laryngismus / Q000628:therapy; D008348:Manikins; D010036:Otolaryngology / Q000193:education*; D010092:Oximetry; D011175:Positive-Pressure Respiration; D001261:Pulmonary Atelectasis / Q000628:therapy; D012135:Respiratory Sounds; D012137:Respiratory System; D041742:Upper Gastrointestinal Tract; D014584:User-Computer Interface