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.