ORL emergencies boot camp: using simulation to onboard residents

Sonya Malekzadeh, Kelly M Malloy, Eugenia E Chu, Jared Tompkins, Alexis Battista, Ellen S Deutsch
Laryngoscope 2011, 121 (10): 2114-21

OBJECTIVES/HYPOTHESIS: Incoming otolaryngology residents are expected to triage and manage airway, bleeding, and other emergencies with little prior experience. Simulation-based education has become increasingly important as it provides tools to develop psychomotor skills and judgment early in residency, using realistic experiences while eliminating patient risk. We hypothesize that a Boot Camp course emphasizing basic otolaryngology management will increase participants' confidence and be perceived as useful in developing their knowledge, technical skills, self-confidence, and improving clinical performance, both immediately and 6 months following the course.


METHODS: A 1-day Boot Camp was developed consisting of six technical skills stations (mask ventilation, intubation, flexible laryngoscopy, microlaryngoscopy/bronchoscopy, epistaxis control, and cricothyroidotomy); a session involving telephone inquiry triage, and two complex airway scenarios addressing medical management and emphasizing team leadership. Residents completed questionnaires before, immediately, and 6 months following course completion.

RESULTS: Thirty residents enrolled, 27 participated in the course, and 24 completed all three surveys. Previous experiences and confidence levels were variable; 26 of 30 (87%) identified emergency airway management as a concern before attending the course. A Fisher's exact test demonstrated improved confidence (P < .05) for every skill. An overwhelming majority of participants agreed or strongly agreed the intervention was useful in developing their knowledge, technical skills, self-confidence, and improving clinical performance.

CONCLUSIONS: An intensive, simulation-based Boot Camp addressing airway, bleeding, and other otolaryngology emergencies was successful in improving junior otolaryngology residents' confidence and was perceived as useful in developing knowledge, technical skills, self-confidence, and improving clinical performance.

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