Beth A. Watson, MEd, Marc McDonald, Kash Vahdat, MD, Bushra Khalil, MD, Cynthia Phelps, PhD, Irmgard Willcockson, PhD
For a patient undergoing a medical procedure, airway management is important to ensure the lungs are not aspirated. The fiberoptic bronchoscope has been in used in clinics for airway management and evaluation since 1967. Gaining skill competency requires practicing intubation with the fiberoptic laryngoscope or bronchoscope, usually acquired by a minimum of 10 successful intubations. Current anesthesiology training involves practice on patients and mannequins, requiring oversight by a professional. Additionally, mannequin experience provides an unrealistic view. This module uses online web-based technologies to avoid expense and coordination associated with current learning methods.
The module was developed using real video and incorporates the system of instructional development of Alessi and Trollip. Additionally learning theories of Carl Rogers (Experiential Learning) and Anchored Instruction were utiilized to create an interactive, accessible and meaningful learning environment. The goal of this eLearning module is to provide an experience online as an alternative to using real patients and provide an avenue for needed practice by incorporating real patient video and "walking" the student through the intubation process. This eLearning module allows the students to visualize the view they would get with a fiberoptic bronchoscope with unlimited virtual practice and limited feedback
The eLearning module was tested on Anesthesiology residents online with SurveyGizmo. First year residents were less comfortable but had less prior intubation experience. The second year residents and later were more comfortable. Comments were mostly positive with one suggesting a preface to this module.
This eLearning module has value and was well received.
Successful students will be able to
- Identify when to flex the fiberoptic bronchoscope tip to reach the epiglottis
- Recognize when they reach the esophagus and how to get to the trachea
- Use the lever on the fiberoptic bronchoscope to navigate past the uvula and through the epiglottis and trachea
- Identify how far from the carina the intubation should stop
- For more information on airway management, tools and processes, check out this link at New England Journal of Medicine: content.nejm.org/cgi/video/356/17/e15/
- Also, check out Dr. Ovassapian's Tips and Tricks
- Click here to see the podcast of the raw video of the intubation process at iTunesU. You will need a UT Houston user login and the free iTunes software from Apple.
Experience the use of the fiberoptic bronchoscope in a non-complex patient in this eModule.