title: Training experts in difficult airway management: Evaluation of a continuous professional development program.
abstract: OBJECTIVE
  The Formation de référents aux techniques d'intubation difficile (FRTID) is a French continuing medical education program on difficult airway management. Its objectives are to train experts in the task of training other physicians in their hospitals for better guideline compliance. Our aim was to describe the curriculum of the experts and to evaluate the program's efficacy via a prospective survey.
  
  
  METHODS
  Each participant was asked to complete a questionnaire before (T0), immediately (T1), 6 (T6) and 12 (T12) months after the course. The main criterion was the proportion of the participants who declared that they had implemented at least one action to improve difficult airway management in their institution at 6 months. Other criteria included the proportion of participants who declared that they had modified their own clinical practice and the frequency of use of specific devices assessed on modified Likert numerical rating scales.
  
  
  RESULTS
  Two hundred and forty-four participants were included in the survey. One hundred and three, 91 and 62 participants responded to the T1 (immediately after the course), T6 (6 months later) and T12 (12 months later) questionnaires, respectively; 73 physicians (i.e. 30% of all participants and 80% of the survey responders) declared that they had implemented at least one action likely to optimize the management of difficult airways. On the T6 and T12 questionnaires, 91% and 97% of the responders respectively declared that they had changed their clinical practice. The course has resulted in increased use of transtracheal oxygenation with manual devices (Manujet(®), Enk(®)) and Seldinger cricothyroidotomy as well as paediatric difficult airway techniques such as paediatric sized elastic gum and Airtraq™ or fibrescopic intubation under general anaesthesia with spontaneous ventilation (through a laryngeal mask).
  
  
  CONCLUSIONS
  These data encourage the training of experts in difficult airways. This curriculum is contributing to the dissemination of the recommendations among a large number of practitioners.
authors.affiliation: Service d'anesthésie et de réanimation chirurgicale, Hôtel-Dieu - hôpital Mère-Enfant, CHU de Nantes, place Alexis-Ricordeau, 44093 Nantes cedex 01, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Brisard
authors.affiliation: Service d'anesthésie et de réanimation chirurgicale, Hôtel-Dieu - hôpital Mère-Enfant, CHU de Nantes, place Alexis-Ricordeau, 44093 Nantes cedex 01, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Péan
authors.affiliation: Service d'anesthésie-réanimation, institut Gustave-Roussy, 94800 Villejuif, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Bourgain
authors.affiliation: Réanimation polyvalente, groupe hospitalier Sud Réunion, centre hospitalier Saint-Pierre, Saint-Pierre, Reunion.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Winer
authors.affiliation: Samu 974, département des urgences, centre hospitalier Felix-Guyon, Saint-Denis, Reunion.
authors.forename: Xavier
authors.initials: X
authors.lastname: Combes
authors.affiliation: Service d'anesthésie et de réanimation chirurgicale, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Langeron
authors.affiliation: Service d'anesthésie et de réanimation chirurgicale, hôpital Foch, 40, rue Worth, 91251 Suresnes, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Fischler
authors.affiliation: Service d'anesthésie et de réanimation chirurgicale, Hôtel-Dieu - hôpital Mère-Enfant, CHU de Nantes, place Alexis-Ricordeau, 44093 Nantes cedex 01, France. Electronic address: corinne.lejus@chu-nantes.fr.
authors.forename: Corinne
authors.initials: C
authors.lastname: Lejus
mesh_terms: D000328:Adult; D058109:Airway Management / Q000295:instrumentation; D000768:Anesthesia, General; D000072080:Anesthesiologists; D000776:Anesthesiology / Q000193:education*; D002648:Child; D002983:Clinical Competence; D003413:Cricoid Cartilage / Q000601:surgery; D004521:Educational Measurement; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D017214:Laryngeal Masks; D011446:Prospective Studies; D058996:Quality Improvement; D011795:Surveys and Questionnaires
keywords: Difficult airway management; Medical continuing education