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Simulation training for urgent postnatal fetal tracheal balloon removal: Two learning methods.

Lucy Lehoczky1, Romain Corroenne2, Jimmy Espinoza2

  • 1University of Kansas School of Medicine, Wichita, KS, USA; Baylor College of Medicine Department of Obstetrics and Gynecology, Division of Maternal-Fetal, Medicine, and Texas Children's Hospital Fetal Center, Houston, TX, USA.

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PubMed
Summary

In-person and video training for urgent fetal endoluminal tracheal occlusion (FETO) balloon removal showed similar effectiveness. Both methods adequately prepared medical students for simulated balloon removal, ensuring patient safety in critical situations.

Keywords:
Congenital diaphragmatic herniaFETOFetal endoluminal tracheal occlusionSimulation

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Area of Science:

  • Medical Education
  • Fetal Surgery
  • Neonatal Care

Background:

  • Severe congenital diaphragmatic hernia (CDH) in fetuses necessitates interventions like fetal endoluminal tracheal occlusion (FETO) to improve survival.
  • Urgent removal of the FETO balloon post-delivery is critical to prevent airway obstruction but requires specialized training.
  • The optimal training method for medical staff in urgent FETO balloon removal remains unclear.

Purpose of the Study:

  • To compare the effectiveness of in-person lectures versus online videos for training medical students in urgent FETO balloon removal.
  • To evaluate the impact of different training modalities on the speed and success of simulated FETO balloon removal procedures.

Main Methods:

  • 24 medical students were randomized into two groups: one receiving in-person lecture training, the other online video training.
  • Both training methods covered endoscopic instrument setup, tracheal landmarks, and balloon removal techniques.
  • Participants were assessed using a high-fidelity simulator, measuring time for instrument setup, intubation, balloon localization, and removal attempts.

Main Results:

  • In-person training led to significantly faster instrument setup times compared to video training (p < 0.01).
  • No significant differences were observed between the groups in the time taken to intubate and locate the FETO balloon or in the number of removal attempts.
  • Overall simulation performance, particularly regarding successful balloon removal, was comparable between the two training methods.

Conclusions:

  • Both in-person and online video training methods are equally effective for teaching urgent FETO balloon removal.
  • Medical staff can be adequately trained in critical FETO balloon removal procedures through either modality.
  • Simulation-based assessment confirms comparable proficiency gained from distinct training approaches.