A randomized controlled trial on the effect of educational interventions in promoting airway management skill maintenance

Study objective: This study was conducted to determine the natural history of airway management skill decay and examine the effect of independent prac tice and periodic feedback on airway management skill maintenance. Methods: This prospective, randomized controlled study conducted at Dalhous ie University in Halifax, Nova Scotia, Canada, between November 1997 and Se ptember 1998. A convenience sample of 84 health sciences students with no p rior airway management experience was used. Participants were trained using an advanced airway manikin and then were randomly assigned to control (n=2 4), periodic feedback only (n=30), and independent practice plus periodic f eedback (n=30) groups. Performance was measured by a 52-point weighted chec klist at 0, 16, 25, and 40 weeks after the initial program. Results: Group scores were analyzed using a mixed-model repeated-measures a nalysis of variance and Bonferroni-adjusted P values. Overall group (P=.000 2) and rime (P=.0001) effects were significant. At time 0, there was no sta tistical difference in mean scores between groups (range 45.0 to 45.2). Con trol group performance fell over the first time interval (0 to 16 weeks) (m ean score=34.0, P=.002) and remained lower at ail intervals without further significant change. Scores in the independent practice plus feedback group revealed no significant changes over time and were significantly higher th an the control group throughout. Performance in the periodic feedback only group showed a nonsignificant trend to improved performance over the contro l group. Conclusion: Airway management skill performance declines early after initia l training. Independent practice combined with periodic feedback was effect ive in maintaining performance scores in an advanced airway management simu lation. Periodic evaluation with feedback alone showed a nonsignificant tre nd toward improvement over control.