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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
  1. ER emergency medicine, ICU intensive care unit, MVA motor vehicle accident, OTL otolaryngology, PGY post graduate year