title: A home-made animal model in comparison with a standard manikin for teaching percutaneous dilatational tracheostomy.
abstract: OBJECTIVE
  As airway management specialists, thoracic surgeons should be familiar with percutaneous dilatational tracheostomy. To optimize the learning curve, we propose a home-made pig model obtained from a slaughterhouse for training residents in the technical aspects of performing percutaneous dilatational tracheostomy. The satisfaction of the residents' training experience using this model was compared with that using a standard manikin model.
  
  
  METHODS
  Fifty residents participated in the present study. At the end of the session, each participant completed a questionnaire assessing the pig model and the manikin by assigning a score (ranging from 1 to 4) to five specific characteristics including (i) reality of skin turgor; (ii) landmark recognition; (iii) feasibility of the procedure; (iv) reality of the model and (v) preference of each model. The differences between models were statistically analysed.
  
  
  RESULTS
  Forty-five participants completed the study. The pig model, compared with the manikin model, presented a higher value regarding the reality of skin turgor (1.7 ± 0.5 vs 0.4 ± 0.8; respectively, P < 0.0001); landmark recognition (3.8 ± 0.5 vs 2.0 ± 0.5; respectively; P < 0.0001) and reality of the model (3.0 ± 0.8 vs 1.3 ± 1.0; respectively; P < 0.0001). No difference was found regarding the feasibility of the procedure (3.7 ± 0.6 vs 3.5 ± 0.5; respectively, P = 0.1). The pig model was preferred to the manikin (3.2 ± 0.7 vs 1.6 ± 1.0; respectively, P < 0.0001).
  
  
  CONCLUSIONS
  Our pig model allowed residents to develop the skills required for successful percutaneous dilatational tracheostomy. In particular, they developed confidence with certain manoeuvres such as needle and guide-wire placement, dilatation of the trachea and insertion of a cannula, before attempting the procedure on a live patient.
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Fiorelli
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Carelli
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Denise
authors.initials: D
authors.lastname: Angioletti
authors.affiliation: Department of Anaesthesiology, Second University of Naples, Naples, Italy.
authors.forename: Annarita
authors.initials: A
authors.lastname: Orsini
authors.affiliation: Department of Anaesthesiology, Second University of Naples, Naples, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: D'Elia
authors.affiliation: Department of Anaesthesiology, Second University of Naples, Naples, Italy.
authors.forename: Annarita
authors.initials: A
authors.lastname: Torino
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Naples, Italy mario.santini@unina2.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Santini
authors.affiliation: Department of Anaesthesiology, Second University of Naples, Naples, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Ferraro
mesh_terms: D059925:Anatomic Landmarks; D000818:Animals; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D018592:Cross-Over Studies; D004503:Education, Medical, Graduate / Q000379:methods*; D006801:Humans; D007396:Internship and Residency; D007558:Italy; D059032:Learning Curve; D008348:Manikins; D023421:Models, Animal; D009048:Motor Skills; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013552:Swine; D013647:Task Performance and Analysis; D013663:Teaching / Q000379:methods*; D014139:Tracheostomy / Q000193:education*
keywords: Animal model; Manikin; Percutaneous dilatational tracheostomy