title: Simulation model for tracheotomy education for primary health-care providers.
abstract: OBJECTIVE
  We performed this study to evaluate the competency of health-care providers managing patients with tracheotomies, and assess the need for, and efficacy of, a multidisciplinary educational program incorporating patient simulation.
  
  
  METHODS
  The prospective observational study included 87 subjects who manage patients with tracheotomies within a tertiary-care hospital. The subjects completed self-assessment questionnaires and objective multiple-choice tests before and after attending a comprehensive educational course using patient simulation. The outcome measurements included pre-course and post-course questionnaire and test scores, as well as observational data collected during recorded patient simulation sessions.
  
  
  RESULTS
  Before the education and simulation, the subjects reported an average comfort level of 3.3 on a 5-point Likert scale across 10 categories in the questionnaire, which improved to 4.4 after the training (p < 0.0001). The subjects' mean scores improved from 56% on the pre-course test to 91% on the post-course test (p < 0.0001). The specific deficiencies observed during patient simulation scenarios included unfamiliarity with different tracheotomy tube types, misunderstanding of speaking valve physiology, and delayed recognition and treatment of a plugged or dislodged tracheotomy tube.
  
  
  CONCLUSIONS
  There is a significant need for improved tracheotomy education among primary health-care providers. Incorporating patient simulation into a comprehensive tracheotomy educational program was effective in improving provider confidence, increasing provider knowledge, and teaching the skills necessary for managing patients with a tracheotomy.
authors.affiliation: Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors.forename: LeighAnne H
authors.initials: LH
authors.lastname: Dorton
authors.forename: Catherine Rees
authors.initials: CR
authors.lastname: Lintzenich
authors.forename: Adele K
authors.initials: AK
authors.lastname: Evans
mesh_terms: D002983:Clinical Competence; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University; D006801:Humans; D008348:Manikins; D011320:Primary Health Care; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014139:Tracheostomy / Q000193:education*; D014140:Tracheotomy / Q000193:education*
keywords: medical education; patient simulation; tracheostomy; tracheotomy