Translation of national guidelines into local practice

Area of Science:

• Medical Education
• Anesthesiology
• Patient Safety

Background:

• Royal College of Anaesthetists National Audit Project 4 highlighted issues in airway crisis management.
• New training programs were developed to enhance knowledge and skills for airway emergencies.
• A large-scale multimodal training program was implemented to adopt Difficult Airway Society (DAS) guidelines from 2015.

Purpose of the Study:

• To assess the effectiveness of training interventions on anaesthetists' knowledge of difficult airway management.
• To evaluate knowledge retention of DAS guidelines after a targeted teaching program.
• To identify challenges in knowledge retention for safety-critical events.

Main Methods:

• In 2014, knowledge of unanticipated difficult airway management was assessed using questionnaires before and after high-fidelity simulation.
• In 2016, surveys evaluated knowledge of new DAS guidelines pre- and post-implementation of a large-scale teaching program.
• Data collected from anaesthetic teams and individual participants.

Main Results:

• High-fidelity simulations in 2014 led to significant immediate knowledge improvement in 75 delegates.
• In 2016, 185 participants attended a teaching program; more reported training access, but a knowledge gap persisted.
• Specific guideline details were retained by only 15% of participants post-teaching.

Conclusions:

• Immediate knowledge gains from simulation training were observed, but long-term retention of critical airway management guidelines was poor.
• The study questions the effectiveness of current training methods for ensuring lasting knowledge of safety-critical procedures.
• Further investigation is needed into compulsory training and methods to improve knowledge retention across healthcare disciplines.