Simulation in Pediatric Airway Foreign Body & Open Airway Surgery

In this episode of BackTable ENT, Dr. Shah and Dr. Agan discuss simulation programs for complex pediatric airway surgery with Dr. Romaine Johnson from UT Southwestern.

First, Dr. Johnson explains his motivation to start an airway simulation program. In the past, he noticed that emergency airway obstructions were suboptimal educational experiences for his junior residents, so he wanted to create a space in which trainees could build the confidence to prevent severe laryngospasms and bronchospasms and develop familiarity with tools during airway obstruction cases.

Next, Dr. Johnson dives into the airway obstruction course details. He uses live animal simulations because it creates a more realistic situation and provides residents with the tactile sensation of removing a foreign body from tissue. Additionally, with a pig model, trainees are able to observe more audio and visual cues such as monitor statistics and skin color. In order to use live animals, he coordinates closely with anesthesiologists and veterinarians. Dr. Johnson recommends attending simulation courses at least twice a year, as repetition is the most effective method of learning procedural techniques in emergency situations. In addition to guiding residents through removing the foreign body, he encourages residents to play other roles, such as techs and anesthesiologists, to grasp a more complete understanding of the different tasks of each profession involved in airway management.

Finally, Dr. Johnson compares the use of simulations in emergency procedures and routine procedures. For emergency procedures, he emphasizes the importance of finding high-fidelity models. However, in routine procedures that educate trainees on decision making, Dr. Johnson concedes that perfect models are not necessary. He ends the episode by concluding that simulation education is not only beneficial for residents, but also for private practice physicians and academic attendings in order to keep their skills sharp.