Team-based model for non-operating room airway management: validation using a simulation-based study.

Area of Science:

• Medical Education
• Anesthesiology
• Patient Safety

Background:

• Non-operating room (non-OR) airway management poses significant risks.
• Independent practice by residents may contribute to complications.
• This study investigates performance differences in simulated non-OR airway management between solo and team-based resident practice.

Purpose of the Study:

• To compare the performance of anaesthesia residents managing simulated non-OR airway scenarios alone versus in pairs.
• To identify differences in complication recognition and overall performance ratings between solo and team-based approaches.

Main Methods:

• Thirty-six anaesthesia residents were randomized into "Solo" (individual) and "Team" (pairs) groups.
• Participants managed three simulated non-OR airway scenarios, including critical events like asystole and pulseless electrical activity (PEA).
• Performance metrics included time to intubation, complication recognition time, and overall performance ratings.

Main Results:

• While intubation time did not differ, the Team group received significantly higher performance ratings for asystole (8.5 vs 5.5) and PEA (8.5 vs 5.8) scenarios.
• The Team group recognized asystole and PEA significantly faster than the Solo group (10.1s vs 23.5s and 13.3s vs 36.0s, respectively).

Conclusions:

• Team-based practice in simulated non-OR airway management leads to superior resident performance compared to independent practice.
• Residents working in pairs were quicker to diagnose critical events, suggesting improved patient safety.
• Training programs should consider adopting team-based methods for all non-OR airway management to enhance resident competency and patient outcomes.