Journal review

Kovacs G, Bullock G, Ackroyd-Stolarz S, et al. A randomized controlled trial on the effect of educational interventions in promoting airway management skill maintenance. Ann Emerg Med 2000; 36:301-309.

Independent practice with periodic feedback is effective in maintaining skill in advanced airway management, according to this study from Dalhousie University in Halifax, Nova Scotia, Canada. A group of 84 students with no prior airway management experience were trained to perform endotracheal intubation using an advanced airway mannequin. They were divided into three groups: periodic feedback only, independent practice plus periodic feedback, and a control group.

Because advanced airway management is performed infrequently, there are concerns about maintenance of skill competence, note the researchers. The study found that airway management skill performance declines quickly after initial training.

Over the 10-month study, each group was evaluated three times. Competency scores of the control group decreased by 25%, and the group with periodic feedback alone had only slightly better scores. In contrast, the students who received independent practice plus feedback showed no significant decrease in their skills over time and also had higher scores during the study.

The results show that the use of independent practice and periodic observation with feedback were the best way to retain advanced airway management skills. "The study provides a model on which one might design/modify a training program for users such as rural physicians or paramedics," write the researchers.