A Randomized Controlled Trial Comparing Learners' Decision-making, Anxiety, and Task Load During a Simulated Airway Crisis Using Two Difficult Airway Aids
| Autor: | Jerry Green, Matthew Kosemund, Brett A Rebal, Oren Guttman, Abu T Minhajuddin, Eric B. Rosero, Aditee P. Ambardekar, Ravi Bhoja, David W Mercier |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Cognitive model medicine.medical_specialty Epidemiology Clinical Decision-Making Medicine (miscellaneous) Workload Anxiety Education Task (project management) law.invention 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Clinical Protocols Acquired immunodeficiency syndrome (AIDS) Randomized controlled trial Anesthesiology 030202 anesthesiology law medicine Humans Airway Management Simulation Training Difficult airway Education Medical business.industry 030208 emergency & critical care medicine respiratory system medicine.disease respiratory tract diseases Modeling and Simulation Female Clinical Competence medicine.symptom business Airway |
| Zdroj: | Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare. 14:96-103 |
| ISSN: | 1559-713X 1559-2332 |
| Popis: | The American Society of Anesthesiologists (ASA) difficult airway algorithm and the Vortex approach are difficult airway aids. Our objective was to demonstrate that a simpler cognitive model would facilitate improved decision-making during a process such as difficult airway management. We hypothesized the simpler Vortex approach would be associated with less anxiety and task load.Medical students were randomized to the ASA algorithm (n = 33) or Vortex approach (n = 34). All learned basic airway techniques on day 1 of their rotation. Next, they watched a video of their respective aid then managed a simulated airway crisis. We assessed decision-making using a seven-point airway management score and a completeness score. Completeness was at least one attempt at each of four techniques (mask ventilation, supraglottic airway, intubation, and cricothyrotomy). Two validated tools, the State-Trait Anxiety Inventory Form Y and the National Aeronautics and Space Administration Task Load Index, were used to assess anxiety and task load.Students in the Vortex group had higher airway management scores [4.0 (interquartile range = 4.0 to 5.0) vs. 4.0 (3.0 to 4.0), P = 0.0003] and completeness (94.1% vs. 63.6%, P = 0.003). In the ASA group, the means (SD) of National Aeronautics and Space Administration Task Load Index scores of 55 or higher were observed in mental [61.4 (14.4)], temporal [62.3 (22.9)], and effort [57.1 (15.6)] domains. In the Vortex group, only the temporal load domain was 55 or higher [mean (SD) = 57.8 (25.4)]. There was no difference in anxiety.Medical students perform better in a simulated airway crisis after training in the simpler Vortex approach to guide decision-making. Students in the ASA group had task load scores indicative of high cognitive load. |
| Databáze: | OpenAIRE |
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