Development of a Rigorously Designed Procedural Checklist for Emergent Cricothyrotomy for Assessment of Emergency Medicine Resident Performance
Abstract
Learning Objectives: The objective was to create an assessment tool for emergent cricothyrotomy using best practice checklist development and expert consensus.
Introduction/Background: Emergent cricothyrotomy is an infrequently performed, potentially life-saving procedural skill that is essential for emergency physicians to master during residency training. However, opportunities for real-life exposure to perform this procedure during residency is rare and ensuring emergency medicine graduates can perform this procedure correctly is essential. For rare, invasive procedures such as cricothyrotomy, checklist simulation assessments allowing for objective measures are best practice for competency based medical education. However, the literature for performing emergency cricothyrotomy is descriptive, not inclusive of evaluative checklists, and lacking a checklist that allows for multiple cricothyrotomy techniques.
Educational Objectives: The objective was to create an assessment tool for emergent cricothyrotomy using best practice checklist development and expert consensus.
Curricular Design: After an initial checklist was created based on literature review, a modified Delphi approach was used to design a final checklist. A multidisciplinary panel of 13 experts, including emergency medicine physicians and trauma surgeons, reviewed the initial checklist. Feedback was reviewed and subsequent iterations of the checklist were reviewed by the same panel of experts until final consensus of a 27 item dichotomous checklist was achieved.
Impact/Effectiveness: After 3 rounds of revisions, a rigorously developed procedural checklist for emergent cricothyrotomy was created (Figure A). To reach consensus, the checklist included options for several acceptable techniques to correctly perform the procedure. This adds to previously published work by developing a rigorously designed, versatile dichotomous procedure checklist that accounts for various techniques. This checklist can serve as a foundation for the development of a curriculum to ensure graduating residents can correctly perform this critical task prior to graduation.