title: Psychomotor skills training in pediatric airway endoscopy simulation.
abstract: OBJECTIVE
  To develop a robust psychomotor skills curriculum to teach pediatric airway foreign body retrieval and to assess the effect of this curriculum on residents' confidence in and ability to perform the complete task in an infant airway mannequin.
  
  
  METHODS
  Instructional course. Objective Structured Assessment of Technical Skills (OSATS).
  
  
  METHODS
  Surgical simulation laboratory.
  
  
  METHODS
  A half-day simulation-based course was developed to train otolaryngology residents in bronchoscopic foreign body retrieval. This complex psychomotor skill was deconstructed into subtasks. The following curricular learning objectives were presented and assessed: understanding of tracheobronchial anatomy, ability to adequately visualize the larynx with laryngoscopy, proficiency in rigid bronchoscopy, and familiarity with foreign body instrumentation. Residents were objectively evaluated on their ability to perform the complete task on a simulator before and after the course using an OSATS grading system. Confidence in successfully assembling the instruments and completing the task was assessed at these time periods.
  
  
  RESULTS
  Seventeen otolaryngology residents completed the study. Confidence in assembling the instruments and in performing the complete task increased on average by 81% and 43%, respectively (P < .001). Using a 15-point OSATS grading system, the average score for the precourse was 7 and for the postcourse was 11.3 (P < .001).
  
  
  CONCLUSIONS
  Simulation-based subtask training shows promise as an effective and reproducible method to teach the complex psychomotor task of airway foreign body retrieval. Completion of the curriculum led to a significant improvement in residents' confidence in and ability to perform bronchoscopic foreign body retrieval in an infant airway mannequin.
authors.affiliation: Department of Otolaryngology--Head & Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA. jabb0005@umn.edu
authors.forename: Noel
authors.initials: N
authors.lastname: Jabbour
authors.forename: Troy
authors.initials: T
authors.lastname: Reihsen
authors.forename: Robert M
authors.initials: RM
authors.lastname: Sweet
authors.forename: James D
authors.initials: JD
authors.lastname: Sidman
mesh_terms: D001980:Bronchi; D001999:Bronchoscopy / Q000193:education*; D002648:Child; D002983:Clinical Competence; D003198:Computer Simulation; D003479:Curriculum; D005547:Foreign Bodies / Q000628:therapy*; D006801:Humans; D007223:Infant; D007318:Inservice Training; D007396:Internship and Residency; D007828:Laryngoscopy / Q000193:education*; D008348:Manikins; D008910:Minnesota; D010036:Otolaryngology / Q000193:education*; D010372:Pediatrics / Q000193:education*; D011597:Psychomotor Performance; D013525:Surgical Instruments