title: Complex procedural skills are retained for a minimum of 1 yr after a single high-fidelity simulation training session.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Anaesthesia, St Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, Canada M5B 1W8. sylvainboet@gmail.com
authors.forename: S
authors.initials: S
authors.lastname: Boet
authors.forename: B C R
authors.initials: BC
authors.lastname: Borges
authors.forename: V N
authors.initials: VN
authors.lastname: Naik
authors.forename: L W
authors.initials: LW
authors.lastname: Siu
authors.forename: N
authors.initials: N
authors.lastname: Riem
authors.forename: D
authors.initials: D
authors.lastname: Chandra
authors.forename: M D
authors.initials: MD
authors.lastname: Bould
authors.forename: H S
authors.initials: HS
authors.lastname: Joo
mesh_terms: D058109:Airway Management / Q000379:methods*; D000758:Anesthesia; D000776:Anesthesiology / Q000193:education*; D002983:Clinical Competence; D003413:Cricoid Cartilage / Q000601:surgery; D004632:Emergency Medical Services / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy*; D007858:Learning; D008348:Manikins; D015588:Observer Variation; D018401:Sample Size; D016037:Single-Blind Method; D013965:Thyroidectomy; D013997:Time Factors