Table 1 Curriculum Outline: Lectures, procedural skills stations and simulation scenarios for each module
From: Managing the airway catastrophe: longitudinal simulation-based curriculum to teach airway management
Module | Target Learners | Learning Goals and Objectives | Instructional Strategies | Educational Features | Format / Dates |
|---|---|---|---|---|---|
(1) Airway Basics | PGY level: ● 1 Disciplines: ● OTL-HNS ● All residents in Surgical Foundations (i.e. Plastics) ● Family Med ● Internal Med ● Emergency Medicine ● Oromaxillo-facial | Knowledge: Basic Approach to Airway Management | 30-min lecture | Focus on acquiring knowledge and proficiency in technical skills. Clinical management on basic airway scenarios. Participants from multiple residency programs work in parallel to each other, with only limited interaction. | Format: Two half-days Development / Implementation 2008-present Data Collection 2009-present |
Procedural Skills: ● Bag-Mask Ventilation ● Endotracheal Intubation ● Alternative Airway Devices ● Basics of Tracheostomies and Trach Care ● Basics of Emergency Surgical Airway | Hands-on Practice with Task Trainers (30 min each station) | ||||
Clinical Management: ● Anaphylactic shock and airway edema requiring resuscitation ● Esophageal intubation with resulting hypoxemia | Simulation Scenarios with High-fidelity Manikins and Group Debriefing | ||||
(2) Advanced Airway | PGY level: ● 2, 3 Disciplines: ● OTL-HNS ● Anesthesia ● Emergency Medicine ● General Surgery ● Sports Medicine | Knowledge: ● Management of the Difficult Airway | 30-min lecture | Focus on knowledge and skills acquisition and applicability to clinical situations. Introduction of clinical management of more difficult airway scenarios. Residents from multiple programs begin to interact during the simulation scenarios. | Format: One full day Development / Implementation 2010, 2011, 2016, 2017 Data Collection 2010–2011 |
Procedural Skills: ● Advanced Alternative Airway Devices ● Basics of Flexible Bronchoscopy ● Video-Assisted Intubation ● Rigid Bronchoscopy | Hands-on Practice with Task Trainers (45 min/station) | ||||
Procedural Skills: ● Controlled Open Tracheostomy ● Advanced Emergency Surgical Airway | Hands-on Practice with Animal Models (45 min/station) | ||||
Clinical Management: ● Polytrauma requiring resuscitation ● Poor oxygenation post-intubation: Mainstem intubation vs. pneumothorax | Simulation Scenarios with High-fidelity Manikins and Group Debriefing | ||||
(3) Advanced Pediatric | PGY level: • 3, 4 Disciplines: • OTL-HNS | Knowledge: ● Crisis Resource Management ● Techniques of Open Airway Surgery | 30-min lecture 10-min lectures | Emphasis on clinical management of difficult airway cases and on acquisition of CRM skills. Application of technical skills into scenarios with a team leader (within own OTL-HNS silo). CRM simulations begin with 4 subacute airway cases followed by 4 more acute cases. Roles of allied health professionals and other non-OTL physicians are scripted. | Format: Two full days Development / Implementation 2013-present Data Collection 2013, 2015, 2018 |
Procedural Skills ● Rigid Bronchoscopy with Foreign Body Removal ● Flexible Bronchoscopy with Foreign Body Removal | Hands-on Practice with Task Trainers (45 min/station) | ||||
Procedural Skills ● Laryngotracheoplasty ● Harvesting and shaping of rib grafts ● Cricotracheal resection ● Slide tracheoplasty | Hands-on Practice with Animal Models (45 min/station) | ||||
Clinical Management and CRM skills ● Intraoperative management of laryngeal Papillomatosis ● Progressive Laryngeal Fracture ● Progressive Subglottic Stenosis ● Mainstem Foreign Body Aspiration ● Massive Tracheoinnominate Fistula ● Airway Fire from CO2 laser use ● Complete airway bbstruction from tracheal foreign body aspiration ● Acute obstruction and Ludwig’s Angina | 8 Simulation Scenarios with High-fidelity Manikins, and Group Debriefing | ||||
(4) Interdisci-plinary and Interprofessional | PGY level: ● 4, 5 Disciplines: ● OTL-HNS ● Anesthesia ● Pediatric Emergency Medicine ● Pediatric Intensive Care ● Nursing ● RT | Knowledge: ● Unique issues related to Interprofessional and Interspecialty Team Training | 30 min lecture | High stress scenarios with increased case complexity. Full interprofessional and interdisciplinary team with improvisations. Shared decision making, adaptive leadership across different disciplines. | Format: Two to three half days Development / Implementation 2012-present Data Collection 2012, 2015, 2018 |
Clinical Management and CRM Skills ● Trisomy 21 child with croup and possible C-spine instability ● Unanticipated difficult airway in a seizing, obese child ● Sports-related trauma with laryngeal fracture and head injury ● Excessive bleed from tracheostomy tube ● Difficult intraoperative removal of aspirated foreign body ● Massive post-tonsillectomy hemorrhage ● Anaphylaxis from intravenous antibiotic administration ● Airway fire from laser supraglottoplasty ● Acute airway obstruction from postoperative neck hematoma ● MVA polytrauma including mandibular / midface trauma | 12–16 Simulation Scenarios with High-fidelity Manikins and Group Debriefing |