Surgical cricothyroidostomy. Analysis and comparison between teaching and validation models of simulator models

Abstract

<jats:p>ABSTRACT Objective: to compare the acquisition and retention of knowledge about surgical cricothyroidostomy by the rapid four-step technique (RFST), when taught by expository lecture, low fidelity and high-fidelity simulation models. Methods: ninety medical students at UFPR in the first years of training were randomized assigned into 3 groups, submitted to different teaching methods: 1) expository lectures, 2) low-fidelity simulator model, developed by the research team or 3) high-fidelity simulator model (commercial). The procedure chosen was surgical cricothyroidostomy using the RFST. Soon after lectures, the groups were submitted to a multiple-choice test with 20 questions (P1). Four months later, they underwent another test (P2) with similar content. Analysis of Variance was used to compare the grades of each group in P1 with their grades in P2, and the grades of the 3 groups 2 by 2 in P1 and P2. A multiple comparisons test (post-hoc) was used to check differences within each factor (test and group). Statistical significance was considered when p&lt;0.05. Statistical analysis was performed in the statistical software R version 3.6.1. Results: each group was composed of 30 medical students, without demographic differences between them. The mean scores of the groups of the expositive lecture, of the simulator of low fidelity model and of high-fidelity simulator model in P1 were, respectively, 75.00, 76.09, and 68.79, (p&lt;0.05). In P2 the grades were 69.84, 75.32, 69.46, respectively, (p&gt;0.05). Conclusions: the simulation of low fidelity model was more effective in learning and knowledge retention, being feasible for RFST cricothyroidostomy training in inexperienced students.</jats:p>

The Impact of the Fidelity of Simulation on Medical Undergraduate Education: A Meta-Analysis

“…Both high-delity and low-delity simulators can improve students' theoretical knowledge and clinical skills [20]. There is no difference in theoretical knowledge and clinical skills, and similar results have been reported in many studies [8,20,21]. These results may suggest that the teaching effect of LFS can be equivalent to that of HFS in medical undergraduate education.…”

“…Six studies [5,8,10,14,20,21] quantitatively compared the mastery of theoretical knowledge of undergraduate medical students exposed to HFS and LFS.…”

“…However, students who have basic knowledge of clinical skills can re ne their performance by entering the "deep" simulated environment of high-delity simulators [13]. It is completely feasible to conduct low-edlity simulations for students with little experience [21]. This has great educational value.…”

Harnessing power of simulation training effectiveness with Kirkpatrick model in emergency surgical airway procedures

“…Insights into the perception of usability were identified. Efficacy in use of simulator would be higher when the simulator performed well in mimicking entire Cricothyroidotomy procedure in an innovative approach under training environment with physical and psychological safety (e.g., physical comfort, hygiene) [ 26 , 27 ]. The more the vibes of safety were secured in training, the more likely participants would show acceptance to use new simulator instead of procine model in knowledge and skills acquisition and its transfer to daily operation [ 16 , 25 ].…”

“…Urdiales and colleagues evenly distributed 90 doctors into intervention groups: (i) lecture, (ii) low-fidelity simulator, (iii) high-fidelity simulator [ 27 ]. Being examined by 20 multiple choice questions, groups with either simulator statistically outweighed lecture group, representing best performance in knowledge acquisition and retention in group with hands-on experience [ 27 ]. Since Cricothyroidotomy, as sort of hands-on surgical skills on psychomotor domain, could never ever be acquired by training without haptic and tactile sensation [ 28 ].…”