Tracheostomy and Laryngectomy Education for Healthcare Providers

Presentation: A010
Topic: Education / Care Delivery
Type: Poster
Authors: Renee A Basile, MS, PAC1; Lauren LiGreci, MS, CCC, SLP1; Diana Bentz1; Tristan Tham, MD2; Sabreen Bhuiya, BS3; Ansley Roche, MD4
Institution(s): 1Staten Island University Hospital; 2Lenox Hill Hospital; 3Hofstra; 4Yale University


Currently, very little research exists regarding the most effective way of teaching hospital staff how to identify the difference between and manage patients with laryngectomy and tracheostomy. These patients represent a high-risk patient population due to the risk of airway obstruction secondary to inadequate airway tube care and mucus plugging. This study compares educational techniques, both didactic and in-person skills training, and examines improvement in hospital staff knowledge.

Method: Sixty-five participants were included in this prospective study, which included Emergency Department staff nurses, residents and advanced care providers. Each subject completed a required, pre-requisite online session that included a pre-test and self-assessment, an educational lecture, followed by a post-test and self-assessment. Each subject participated in a simulation lab. Participants were randomized into the intervention or the control group. Once in the simulation lab, participants completed a pre-simulation self-assessment, then four simulation skill stations, which addressed pre-defined skills and case scenarios. Participants in the intervention group then viewed a didactic video, then completed the same four skills stations. The control group viewed the didactic video after completing the four skills stations a second time, such that control group performed the skills in the simulation without any video intervention in between. Post-test assessments were completed by all participants. The skills performed were audiovisually recorded and each video was graded on a pre-determined grading system by three study personnel. Pre and post quiz and practical scores were compared using paired t-test when comparing within groups and independent t-test across groups.

Results: Both the intervention and the control groups in the cohort showed improvements in post-test assessments including the quiz (control arm P = 0.0008, intervention arm P = 0.0007), self -assessment (control arm P < 0.0001, intervention arm P < 0.0001), and practical skills assessment (control arm P < 0.0001, intervention arm P < 0.0001). There were no significant baseline differences in pre-test scores between the intervention and control arm. Lastly, there were no significant differences observed between groups in post-test scores.

Conclusion: This study demonstrates a global increase in hand-on clinical skills and self-assessment scores for participants regardless of receiving an additional teaching video during the hands-on clinical skills session when participating in an educational course of laryngectomy and tracheostomy care. The addition of a video lecture to a hands-on skills course may be of limited utility.