title: Self-directed simulation-based training of emergency cricothyroidotomy: a route to lifesaving skills.
abstract: The emergency cricothyroidotomy (EC) is a critical procedure. The high cost of failures increases the demand for evidence-based training methods. The aim of this study was to present and evaluate self-directed video-guided simulation training. Novice doctors were given an individual 1-h simulation training session. One month later, an EC on a cadaver was performed. All EC's were video recorded. An assessment tool was used to rate performance. Performance was compared with a pass/fail level for the EC. We found a high reliability, based on Pearson's r (0.88), and a significant progression of skill during training (p < 0.001). Eleven out of 14 succeeded in creating an airway on the cadaver in 64 s (median, range 39-86 s), but only four achieved a passing score. Our 1-h training protocol successfully raised the competence level of novice doctors; however, the training did not ensure that all participants attained proficiency.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark. Jacob.melchiors@gmail.com.|Copenhagen Academy for Medical Education and Simulation, Copenhagen, The Capital Region of Denmark, Denmark. Jacob.melchiors@gmail.com.
authors.forename: Jacob
authors.identifier: http://orcid.org/0000-0002-9929-9350
authors.initials: J
authors.lastname: Melchiors
authors.affiliation: Copenhagen Academy for Medical Education and Simulation, Copenhagen, The Capital Region of Denmark, Denmark.
authors.forename: Tobias
authors.initials: T
authors.lastname: Todsen
authors.affiliation: Copenhagen Academy for Medical Education and Simulation, Copenhagen, The Capital Region of Denmark, Denmark.
authors.forename: Philip
authors.initials: P
authors.lastname: Nilsson
authors.affiliation: Copenhagen Academy for Medical Education and Simulation, Copenhagen, The Capital Region of Denmark, Denmark.
authors.forename: Andreas Pagh
authors.initials: AP
authors.lastname: Kohl
authors.affiliation: Department of Anesthesia, Center of Head and Orthopedics, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Bøttger
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.
authors.forename: Birgitte
authors.initials: B
authors.lastname: Charabi
authors.affiliation: Copenhagen Academy for Medical Education and Simulation, Copenhagen, The Capital Region of Denmark, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Konge
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: von Buchwald
mesh_terms: D000328:Adult; D002102:Cadaver; D002983:Clinical Competence; D003413:Cricoid Cartilage / Q000601:surgery*; D004630:Emergencies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007318:Inservice Training; D007396:Internship and Residency; D008297:Male; D011380:Programmed Instructions as Topic; D015203:Reproducibility of Results; D014741:Video Recording
keywords: Airway management; Cricothyroidotomy; Self-directed training; Simulation; Surgical skills training