Instructor-based real-time multimedia medical simulation to update concepts of difficult airway management for experienced airway practitioners.

BACKGROUND: We integrated lecture, real-time multimedia display and medical simulation into a new renewal airway management training protocol for experienced nurse anesthetists.

METHODS: Trainees of the Taiwan Association of Nurse Anesthetists from northern Taiwan and junior residents from our department were enrolled into the training program. A 4-hour renewal curriculum in the management of airway emergencies was developed, which consisted of a 2-hour general lecture (including 4 divided sections) and a 2-hour instructor-based real-time multimedia medical simulation of 4 specific techniques. After detailed explanation of each specific instrument at the beginning of each simulation, the instructors demonstrated accurate and successful management of 4 airway crises from clinical experience by using a standardized human patient simulator situated on the stage of the conference room. Meanwhile, real-time display of instructors' performance, responsive physical parameters and images from specific instruments were conducted by video camera and video processor, and projected on a 3-frame screen. Brief summary and feedback were performed after each simulation. Trainees completed a questionnaire 6 months after they participated in the training program.

RESULTS: Two hundred and forty-two nurse anesthetists and 13 young residents were trained with this protocol. The questionnaire revealed that the renewal training program was useful. Participants updated their knowledge of difficult airway management, gained more confidence, improved performance, and provided effective assistance in handling airway crises.

CONCLUSION: Renewing practice guidelines and teaching airway management skills, especially for difficult airway crises and protection of personnel, continues to be an important issue. Instructor-based real-time multimedia simulation is a fast, useful and systematic renewal educational method for many participants with extensive experience of airway management to update their knowledge about difficult airway management, and acquire improved decision-making and communication capabilities, skills of specific airway management.