Impact of simulation-based training on difficult airway management among anesthesia trainees and nurses as real team

Difficult airway management is a critical skill requiring quick decision-making and effective team coordination. However, healthcare workers often lack real-life experience due to rarity of such instances. The aim of this study was to evaluate the effectiveness of simulation-based training for difficult airway management on real teams.

A prospective quasi-experimental study was conducted with 24 participants divided into six teams, each comprising three resident doctors and one staff nurse. An initial baseline simulation (S0) was conducted, followed by didactic sessions and skill training. Subsequent simulation sessions were carried out two weeks after the skill training (S1) and again six months later (S2). The primary objective was to evaluate the improvement in skills of real teams by comparing checklist scores. Simultaneously, retention of these skills and behaviour changes in real-world clinical practice were also assessed. Data were analyzed using descriptive and inferential statistics.

Notable improvement in team performance was observed during post-skill training simulations compared to baseline, as demonstrated by a significant increase in technical and non-technical skill scores [mean (SD): 26.7 (6.3) at S0 to 67.8 (7.3) at S1; P < 0.001]. Critical airway management skills, including time to call for help, deliberation time, and cricothyroidotomy time, also showed significant improvement. Skill retention was observed at the six-month simulation session [mean (SD) at S2 66.8 (4.1); P = 0.7]. Participants and observers reported increased confidence and situational awareness in real-world settings.

This single-institute multi-professional team training resulted in significant improvement and retention of technical and non-technical skills of real teams in managing difficult airway.