Accepted Type
Dedicated Poster
Code
LP12 - 7
Acceptance Declaration
Accept
Additional Information
I declare I have no actual or potential conflict of interest in relation to this program.
Was this work accepted for CCME 2020?
yes
Category
General Call (Workshop, Oral Presentation, Poster Presentation)
Type
Poster
Sub Type
Education Research
Will the presenter be a:
Jr. Faculty (less than 5 years in practice)
Affiliation
Title
Impact of stress on the performance of neonatal endotracheal intubation: a randomized controlled trial on manikins.
Length of Presentation
Background/Purpose
Although a required skill in pediatric residency programs, success rate of neonatal endotracheal intubation (NETI) among trainees is low. NETI is taught using simulation with limited short-term retention of skill. In the clinical setting, NETI is associated with stress, which effect on success is poorly studied. The objective is to assess the impact of stress on the success of simulated NETI.
Methods
Crossover randomized controlled trial. Pediatric residents randomized to perform NETI in low (LS) or high stress (HS) environment, and then crossover. Stress was created using audio alarms, third party supervisors and simulated manikin instability. Stress of participants was assessed at rest, before and after each scenario. Stress assessment included: salivary cortisol, heart rate and the State Anxiety Inventory (STAI) questionnaire. Primary and secondary outcomes include: success rate, time to successful intubation and stress levels. Success rate was analyzed using chi2 and continuous variables were analyzed using paired t-test and repeated measures ANOVA.
Results
49 residents (97 NETI) have been recruited and have completed the study. Success rate in the HS group was 60% vs 51% in LS (p=0.41). There was no significant difference with regards to duration of NETI, duration of scenario or salivary cortisol. Heart rate was significantly different between HS and LS groups (p<0.001). The STAI result was also significantly different between HS and LS groups (p=0.01).
Conclusion
Among stress markers, the heart rate and STAI increase significantly more in the HS setting. The stable cortisol level suggest that stress lived by the resident does not create a sense of loss of control or distress. These findings suggest that the HS setting is an appropriate training tool for stress preparedness for neonatal ETI.
Keyword 1
stress
Keyword 2
endotracheal intubation
Keyword 3
procedural training
Level of Training
Post Graduate
Abstract Themes
Teaching and learning
Teaching and Learning
- Clinical Skills
- Simulation
Additional Theme (First choice)
Postgraduate
Additional Theme (Second Choice)
Additional Theme (Third Choice)
Authors
Presenter
Michael-Andrew Assaad
Term 1
Yes
Term 2
Yes
Term 3
Yes
Term 4
Yes
Term 5
Yes
