title: Effect of performance feedback on tracheal suctioning knowledge and skills: randomized controlled trial.
abstract: OBJECTIVE
  This paper is a report of a study to determine whether individualized performance feedback improved nurses' and physiotherapists' knowledge and practice of tracheal suctioning.
  
  
  BACKGROUND
  Nurses' knowledge and practice of tracheal suctioning is often deficient. Whilst teaching has been shown to improve suctioning knowledge and practice, this is not sustained over time.
  
  
  METHODS
  Ninety-five qualified healthcare professionals (nurses and physiotherapists) in two acute hospitals were randomly allocated to receive either individualized performance feedback or no additional feedback after a standardized lecture and practical demonstration of tracheal suctioning. Randomization was stratified by profession, seniority and site. Data were collected in 2005 in a clinical setting involving patients and a simulation setting. The outcome measures were knowledge and practice of tracheal suctioning, assessed by self-completion questionnaire and structured observation.
  
  
  RESULTS
  In both settings, intervention groups performed statistically significantly better in terms of knowledge (P = 0.014) and practice (P = 0.037) at final follow-up. Those who received performance feedback had statistically significantly higher knowledge (P = 0.004) and practice (P < 0.01) scores than the control group. For practice, there was also a relationship between professions (P < 0.01), with physiotherapists performing better than nurses overall, and an interaction between group and setting (P < 0.01), with performance feedback showing a stronger positive effect in the simulation setting.
  
  
  CONCLUSIONS
  Retention of knowledge and tracheal suctioning practice is improved when training is followed up by tailored feedback on performance. Further research would shed light on how long such improvements are sustained, and whether the improvements seen in a simulated setting can be generalized to clinical settings.
authors.affiliation: Florence Nightingale School of Nursing & Midwifery, King's College London, UK. tina.day@kcl.ac.uk
authors.forename: Tina
authors.initials: T
authors.lastname: Day
authors.forename: Nicola
authors.initials: N
authors.lastname: Iles
authors.forename: Peter
authors.initials: P
authors.lastname: Griffiths
mesh_terms: D000488:Allied Health Personnel / Q000193:education* / Q000592:standards; D004812:Epidemiologic Methods; D055317:Evidence-Based Practice / Q000458:organization & administration; D030141:Feedback, Psychological; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007442:Intubation, Intratracheal / Q000592:standards*; D008131:London; D009741:Nursing Staff, Hospital / Q000193:education* / Q000592:standards; D026761:Physical Therapy Specialty / Q000193:education; D013396:Suction / Q000193:education* / Q000592:standards