A Multidisciplinary Basic Airway Skills Boot Camp for Novice Trainees

Introduction: Otolaryngology and anesthesiology residents may be the first responders to airway emergencies, even in the first weeks of training. These residents may be unfamiliar with the armamentarium of airway maneuvers, the most basic of which may be lifesaving. Boot camp education has been demonstrated to be effective in multiple disciplines. In this study, we examine whether an immersive, multidisciplinary boot camp style simulation course leads to an improvement in novice airway provider confidence. Methods: Novice otolaryngology and anesthesiology residents participated in an annual (2013-2018) multidisciplinary boot camp simulation course. Residents completed an anonymous pre- and post-test self-assessment tool reporting their confidence for airway skills and concepts from the curriculum. Responses were on a Likert scale from 1 to 5 (1=no familiarity, 5=extremely comfortable). We analyzed pre- and post-course participant self-reported comfort level with the airway management skills and concepts addressed in the course. Frequencies and percentages were reported. Fisher’s exact test was used to assess statistical significance at level 0.05. Results: A total of 62 residents, including 50 anesthesiology residents and 12 otolaryngology residents, completed a post-test self-assessment tool. For all topics covered in the course, there was a statistically significant change in the percentage of residents who reported familiarity with the topic (p<0.001). This corresponded to an increase in self-reported comfort level and a decrease in non-familiarity or discomfort with the airway topics covered in the course. The greatest increase in percentage of residents reporting feeling comfortable or extremely comfortable with the task after completion of the simulation boot camp were all moderately advanced airway maneuvers (laryngeal mask airway [LMA] placement, flexible fiberoptic intubation, glidescope intubation, endotracheal intubation, and two-person mask ventilation). The greatest decrease in non-familiarity or discomfort was seen in moderately complex to advanced airway topics (fiberoptic intubation, glidescope intubation, intubating LMA, rigid bronchoscopy, cricothyroidotomy, tracheostomy, and laryngectomy). Conclusions: Our data support the use of immersive surgical boot camp experiences to enhance resident familiarity and comfort and decrease unfamiliarity and discomfort with a wide variety of airway topics and maneuvers.