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Table 4 Common didactic sessions and simulation scenarios in OHNS boot camps

From: The Otolaryngology boot camp: a scoping review evaluating commonalities and appraisal for curriculum design and delivery

Study

Didactic Sessions

Simulation Scenarios and Feedback

Washington, USA Group

No formal lectures

Faculty demonstration prior to each skill station

Faculty led case-based exercise exploring common OHNS call scenarios with discussion facilitated by electronic audience response systems

Two team simulation scenarios:

 Hematoma with airway obstruction after thyroid surgery

 Angioedema resulting in airway obstruction

Faculty-led debrief sessions immediately after simulation designed to address communication, teamwork, decision making, and technical skills

Canadian Group

No formal lectures

1-h task trainer exercises were provided with faculty supervision and instruction if necessary

Interactive panel discussion on 16 common emergency clinical scenarios

Two high-fidelity emergency scenario simulations:

 Post-thyroidectomy hematoma

 Facial trauma (Facial fracture with difficult oral intubation)

Group and individual feedback with faculty post-simulation with video recording

UK Group

Focused lectures in small group organized in two parts:

 1. Formal didactic training delivered covering basic systematic assessment of the critically ill patient using ALS and ATLS guidelines

 2. Common OHNS topics: airway management, head and neck, rhinology, otology, audiology, pediatric, operations and perioperative care, and radiology

For practical skills sessions participants received hands-on instruction from faculty on task trainers

Five teamwork simulation sessions:

 Airway obstruction

 Epistaxis and resuscitation

 Post-tonsillectomy bleed

 Neck Trauma

 Post-laryngectomy care

Each candidate worked through scenario as either leader or assistant with faculty guidance if needed. Performance videotaped and structured feedback was provided by faculty after sessions

New York, USA Group (NYU)

Formal didactic and video lectures delivered by faculty covering airway evaluation and management with emphasis on difficult airways

Six difficult airway cases designed to test team performance (no details)

Team debrief post simulation. Video recorded sessions were randomized and analyzed by three academic OHNS staff on four domains: preparation, clinical reasoning, knowledge, and non-technical skills

New York Group (AECM)

eaching organized into formal didactic sessions and technical skills development

Ten, two-hour didactic lectures were offered by attending physicians which covered: introduction to the operating room and basic instruments, flexible laryngoscopy, bronchoscopy, tracheostomy, epistaxis management, laser safety, and subspecialty specific orientations (head and neck, rhinology, and otology)

Eight total simulations falling in to three categories:

 Airway simulation. Scenarios included: angioedema, laryngospasm, trismus, and oropharyngeal bleeding

 Epistaxis and bleeding neck simulation. Scenarios included: anterior nasal bleed, posterior nasal bleed, expanding hematoma

 Team based simulation scenarios. Scenarios included: dislodged tracheostomy tube, post-obstructive pulmonary edema, postoperative stroke, postoperative safe handoff, malignant hyperthermia, epiglottitis, and loss of airway

Faculty observed trainees during simulation for demonstration of clinical skills, critical thinking, situational awareness, professionalism, and effective communication. Follow simulations trainees were debriefed on their performance

Ecuador Group

Formal didactic lectures in part of the first half of each day that covered: a review of relevant anatomy, disease processes, facial analysis, and surgical management for each scenario. The second half of the day was spent in live surgery training

Residents were also given a flash drive with reading materials, lectures and videos to review

In part of the first half of the day, time was spent practicing pertinent facial analysis and participating in three simulations:

 Microtia

 Nasoseptal deformities

 Facial paralysis

 Residents performed while being observed by visiting surgeons and received instruction if necessary. If a resident missed part of the sessions, material was reviewed with them separately. Residents were instructed on proper photo documentation for rhinoplasty as well as intraoperative record keeping with Gunter diagrams

California, USA Group

No formal didactic lectures

Used cadaveric task trainers in the morning to teach procedural skills followed by simulation-based curriculum in the afternoon

Simulations used included:

 Airway fire during tracheostomy

 Pediatric respiratory code during airway evaluation

 Dislodged pediatric tracheostomy tube in the ICU

 Angioedema in the emergency department with the inability to intubate or ventilate

The task trainers and simulations were run by faculty from the participating institutions

  1. OHNS: Otolaryngology–head and neck surgery, ALS: advanced life support, ATLS: advanced trauma life support