Anesthesiologists’ airway management expertise: Identifying subjective and objective knowledge gaps

Abstract

Background Failure in airway management continues to cause preventable patient harm, and the recommended continuing education is challenged by anesthesiologists’ unknown knowledge gaps. This study aimed to identify anesthesiologists’ subjective and objective knowledge gaps as well as areas where anesthesiologists are incorrect and unaware. Methods An adaptive E‐learning program with 103 questions on adult airway management was used for subjective and objective assessment of anesthesiologists’ knowledge. All anesthesiologists in the Capital Region of Denmark were invited to participate. Results The response rate was 67% (191/285). For preoperative planning, participants stated low confidence (subjective assessment) regarding predictors of difficult airway management in particular (69.1%‐79.1%). Test scores (objective assessment) were lowest for obstructive sleep apnea as a predictor of difficult airway management (28.8% correct), with participants being incorrect and unaware in 33.5% of the answers. For optimization of basic techniques, the lowest confidence ratings related to patient positioning and prediction of difficulties (57.4%‐83.2%), which agreed with the lowest test scores. Concerning advanced techniques, videolaryngoscopy prompted the lowest confidence (72.4%‐85.9%), while emergency cricothyrotomy resulted in the lowest test scores (47.4%‐67.8%). Subjective and objective assessments correlated and lower confidence was associated with lower test scores: preoperative planning [r = −.58, P < .001], optimization of basic techniques [r = −.58, P = .002], and advanced techniques [r = −.71, P < .001]. Conclusion We identified knowledge gaps in important areas of adult airway management with differing findings from the subjective and objective assessments. This underlines the importance of objective assessment to guide continuing education.

Preparing for obstetric anaesthesia—An educational randomised controlled trial comparing e‐learning to written course material

“…Assessment of physicians' knowledge and skills enables identification of learning needs, which can be used to optimise and focus educational efforts. A further development is adaptive e‐learning, which has been successfully used in anaesthesia for training and assessment in airway management 41 . Adaptive e‐learning is a promising field, combining assessment and learning analytics to deliver content specifically to the needs of the individual.…”

“…A further development is adaptive e‐learning, which has been successfully used in anaesthesia for training and assessment in airway management. 41 Adaptive e‐learning is a promising field, combining assessment and learning analytics to deliver content specifically to the needs of the individual. According to initial results, adaptive e‐learning raises performance well beyond normal e‐learning or other conventional instructional designs.…”

Continuing professional development (CPD) for anesthetists: A systematic review

“…Finally, one study utilized an e-learning program with MCQs to assess subjective and objective knowledge gaps in airway management, highlighting the need for objective measurements. 14 Of the studies investigating the effect of the assessment process, two evaluated the impact of receiving feedback, identifying a positive impact on technical crisis management skills but a neutral effect on nontechnical skills. The third study reported a positive effect of auditing on performance of peripheral nerve blocks.…”

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