Skill retention of advanced airway techniques after simulation training - a randomized prospective study

Area of Science:

• Medical Education
• Emergency Medicine
• Anesthesiology

Background:

• Front of Neck Access (FONA) is a critical emergency procedure for airway management when conventional methods fail.
• Maintaining FONA proficiency is vital for healthcare professionals in acute care settings.
• Traditional training methods are costly and time-consuming, necessitating alternative approaches.

Purpose of the Study:

• To evaluate the non-inferiority of skill retention for the FONA procedure after three months when trained on a self-made model compared to a high-fidelity manikin.
• To assess the effectiveness of low-cost training models for essential airway management skills.

Main Methods:

• A randomized prospective trial involving 44 anaesthesiology residents divided into two groups.
• Group A trained on a self-made FONA model; Group B trained on a commercial high-fidelity simulator (SimMan® 3G).
• Skill retention was assessed after three months using a FONA checklist and time to first successful ventilation.

Main Results:

• The self-made model group showed non-inferior skill retention, with a mean FONA score difference of -0.56 points compared to the high-fidelity model.
• The mean procedural time difference after three months was +3.6 seconds favoring the self-made model.
• The results demonstrated that the self-made model met the non-inferiority margin for skill retention.

Conclusions:

• FONA skill training using a self-made, low-cost model is non-inferior to high-fidelity simulation for three-month skill retention.
• Accessible and affordable training models can effectively maintain critical airway management skills.
• This approach is suitable for institutions lacking advanced simulation equipment.