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Interprofessional simulation training in difficult airway management: a narrative review

09 January 2020
Volume 29 · Issue 1


The aim of this narrative literature review was to explore the impact of interprofessional simulation-based team training on difficult airway management. The Fourth National Audit Project of The Royal College of Anaesthetists and The Difficult Airway Society identified recurrent deficits in practice that included delayed recognition of critical events, inadequate provision of appropriately trained staff and poor collaboration and communication strategies between teams. Computerised databases were assessed to enable data collection, and a narrative literature review and synthesis of eight quantitative studies were performed. Four core themes were identified: debriefing, measures of assessment and evaluation, non-technical skills and patient safety, and patient outcomes. There are many benefits to be gained from interprofessional simulation training as a method of teaching high-risk and infrequent clinical airway emergencies. The practised response to emergency algorithms is crucial and plays a vital role in the reduction of errors and adverse patient outcomes.

Krage and Erweteman (2015) identified a positive change in traditional teaching methods for the development of technical skills in anaesthesia from supervised practice to one learnt through simulation. Simulation allows learners to encounter rare clinical situations, such as a difficult airway, enabling them to gain practical experience before having to deal with high-risk situations in clinical practice with possibly no senior medical support immediately available (Lorello et al, 2014). Simulation is significant in improving both technical and non-technical skills in dealing with critically ill patients and ultimately patient safety (Fox-Robichaud and Nimmo 2007; Murphy et al, 2016; Peters et al, 2018; Jensen et al, 2019). Dieckmann et al (2007) noted that non-technical skills include teamwork, leadership, decision-making, situational awareness and, most importantly, effective communication. Greenland et al (2011) emphasised the importance of non-technical skills as well as technical competence in the management of the difficult airway. However, Jensen et al (2019) stated that high-fidelity simulation is costly and there remains a lack of evidence to support its impact on patient outcomes.

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