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Prospective Randomized Controlled Trial of Video- Versus Recall-Assisted Reflection in Simulation-Based Teaching on Acquisition and Retention of Airway Skills Among Trainees Intubating Critically Ill Patients.
Crit Care Med. 2020 Jun 26 [Online ahead of print]CC

Abstract

OBJECTIVES

Conventionally, simulation-based teaching involves reflection on recalled events (recall-assisted reflection). Instead of recall, video-assisted reflection may reduce recall bias and improve skills retention by contributing to visual memory. Here, we test the hypothesis that when compared with recall, video-assisted reflection results in higher acquisition and retention of skills involved in airway management among junior critical care doctors.

DESIGN

Randomized control trial. Participants were randomized 1:1 to video-assisted reflection or recall-assisted reflection group.

SETTING

University-affiliated tertiary care center.

SUBJECTS

Junior critical care doctors.

INTERVENTION

Video-assisted reflection.

MEASUREMENTS AND MAIN RESULTS

All participants underwent simulation-based teaching of technical and nontechnical airway skills involved in managing a critically ill patient. These skills were assessed before, post-workshop, and in the following fourth week, by two independent blinded assessors using a validated scoring tool. Quality of debrief was assessed using a validated questionnaire. Repeated-measures analysis of variance was used to assess time and group interaction. Forty doctors were randomized. At baseline, the groups had similar airway experience (p = 0.34) and skill scores (p = 0.97). There was a significant interaction between study groups and changes over time for total skill scores (F[2, 37] = 4.06; p = 0.02). Although both the study groups had similar and significant improvement in total skills scores at the postworkshop assessment, the decline in total skills scores at delayed assessment (F[1, 38] = 5.64; p = 0.02) was significantly more in the recall-assisted reflection group when compared with the video-assisted reflection group. This resulted in lower mean skill scores in the recall-assisted reflection group when compared with the video-assisted reflection group in the delayed assessment (89.45 [19.32] vs 110.10 [19.54]; p < 0.01). Better retention was predominantly in the nontechnical skills. The perceived quality of debrief was similar between the two groups.

CONCLUSION

When compared with recall, video-assisted reflection resulted in similar improvement in airway skills, but better retention over time.

Authors+Show Affiliations

1College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia. 2Intensive Care, Flinders Medical Centre, Bedford Park, SA, Australia. 3Department of Anaesthesia, Flinders Medical Centre, Bedford Park, SA, Australia. 4Division of Medicine, Southern Adelaide Health Network, Adelaide, SA, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32618692

Citation

Prakash, Shivesh, et al. "Prospective Randomized Controlled Trial of Video- Versus Recall-Assisted Reflection in Simulation-Based Teaching On Acquisition and Retention of Airway Skills Among Trainees Intubating Critically Ill Patients." Critical Care Medicine, 2020.
Prakash S, Bihari S, Laver R, et al. Prospective Randomized Controlled Trial of Video- Versus Recall-Assisted Reflection in Simulation-Based Teaching on Acquisition and Retention of Airway Skills Among Trainees Intubating Critically Ill Patients. Crit Care Med. 2020.
Prakash, S., Bihari, S., Laver, R., Chandran, G., Kerr, L., Schuwirth, L., & Bersten, A. (2020). Prospective Randomized Controlled Trial of Video- Versus Recall-Assisted Reflection in Simulation-Based Teaching on Acquisition and Retention of Airway Skills Among Trainees Intubating Critically Ill Patients. Critical Care Medicine. https://doi.org/10.1097/CCM.0000000000004448
Prakash S, et al. Prospective Randomized Controlled Trial of Video- Versus Recall-Assisted Reflection in Simulation-Based Teaching On Acquisition and Retention of Airway Skills Among Trainees Intubating Critically Ill Patients. Crit Care Med. 2020 Jun 26; PubMed PMID: 32618692.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective Randomized Controlled Trial of Video- Versus Recall-Assisted Reflection in Simulation-Based Teaching on Acquisition and Retention of Airway Skills Among Trainees Intubating Critically Ill Patients. AU - Prakash,Shivesh, AU - Bihari,Shailesh, AU - Laver,Russell, AU - Chandran,Giresh, AU - Kerr,Lachlan, AU - Schuwirth,Lambert, AU - Bersten,Andrew, Y1 - 2020/06/26/ PY - 2020/7/4/pubmed PY - 2020/7/4/medline PY - 2020/7/4/entrez JF - Critical care medicine JO - Crit. Care Med. N2 - OBJECTIVES: Conventionally, simulation-based teaching involves reflection on recalled events (recall-assisted reflection). Instead of recall, video-assisted reflection may reduce recall bias and improve skills retention by contributing to visual memory. Here, we test the hypothesis that when compared with recall, video-assisted reflection results in higher acquisition and retention of skills involved in airway management among junior critical care doctors. DESIGN: Randomized control trial. Participants were randomized 1:1 to video-assisted reflection or recall-assisted reflection group. SETTING: University-affiliated tertiary care center. SUBJECTS: Junior critical care doctors. INTERVENTION: Video-assisted reflection. MEASUREMENTS AND MAIN RESULTS: All participants underwent simulation-based teaching of technical and nontechnical airway skills involved in managing a critically ill patient. These skills were assessed before, post-workshop, and in the following fourth week, by two independent blinded assessors using a validated scoring tool. Quality of debrief was assessed using a validated questionnaire. Repeated-measures analysis of variance was used to assess time and group interaction. Forty doctors were randomized. At baseline, the groups had similar airway experience (p = 0.34) and skill scores (p = 0.97). There was a significant interaction between study groups and changes over time for total skill scores (F[2, 37] = 4.06; p = 0.02). Although both the study groups had similar and significant improvement in total skills scores at the postworkshop assessment, the decline in total skills scores at delayed assessment (F[1, 38] = 5.64; p = 0.02) was significantly more in the recall-assisted reflection group when compared with the video-assisted reflection group. This resulted in lower mean skill scores in the recall-assisted reflection group when compared with the video-assisted reflection group in the delayed assessment (89.45 [19.32] vs 110.10 [19.54]; p < 0.01). Better retention was predominantly in the nontechnical skills. The perceived quality of debrief was similar between the two groups. CONCLUSION: When compared with recall, video-assisted reflection resulted in similar improvement in airway skills, but better retention over time. SN - 1530-0293 UR - https://www.unboundmedicine.com/medline/citation/32618692/Prospective_Randomized_Controlled_Trial_of_Video-_Versus_Recall-Assisted_Reflection_in_Simulation-Based_Teaching_on_Acquisition_and_Retention_of_Airway_Skills_Among_Trainees_Intubating_Critically_Ill_Patients L2 - https://dx.doi.org/10.1097/CCM.0000000000004448 DB - PRIME DP - Unbound Medicine ER -
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