Residents as teachers: Optimizing the benefit of a difficult airway management simulation session

Abstract

© 2019 Tachawan Jirativanont et al., published by Sciendo. Simulation is widely used in airway management training. To show that assigning anesthesia residents' simulation educator roles improved cognitive learning outcomes. Postgraduate second- and third-year (PGY-2 and PGY-3) anesthesia residents were randomly assigned to three groups: a teacher group (T), a hot-seat (active participant) group (H), and an observer group (O). After a train-the-trainer session, the T group prepared simulation scenarios for difficult airway management and then conducted the simulation sessions and post-session debriefing. The H group participated in the scenarios, and the O group observed the sessions. All participants attended the post-session debriefing. Evaluation was conducted at pretest, immediate posttest, and 3 months (retention test). Score differentiation and average normalized gain were calculated. Participants completed a post-simulation class survey. Participants were 49 residents (PGY-2 = 24, PGY-3 = 25). The T group had the highest posttest score (17.06 ± 1.23); this score significantly differed from the O group (14.75 ± 2.57, P = 0.003) but not the H group (15.64 ± 1.54, P = 0.103). The average normalized gain was significantly higher in the T group than in the H and O groups (0.51 ± 0.22, 0.18 ± 0.32, and 0.17 ± 0.47, respectively; P = 0.012). Participants retained knowledge at 3 months after the session, with no significant differences among the groups. Most participants (45%) preferred to be active scenario participants, and 20% preferred to teach. Overall satisfaction was high in all groups. This study showed that a teaching role can be effectively applied for residents in simulation-based education on difficult airway management to support better learning outcomes.