• Phillip S LoSavio, Michael Eggerstedt, Bobby A Tajudeen, Peter Papagiannopoulos, Peter C Revenaugh, Pete S Batra, and Inna Husain.
• Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, Chicago, IL 60612, United States of America.
• Am J Otolaryngol. 2020 Sep 1; 41 (5): 102574.

ObjectiveTo determine if rapid implementation of simulation training for anticipated COVID-19 tracheostomy procedures can increase physician confidence regarding procedure competency and use of enhanced personal protective equipment (PPE).MethodsA brief simulation training exercise was designed in conjunction with the development of a COVID-19 Tracheostomy Protocol. The simulation training focused primarily on provider safety, pre and post-surgical steps and the proper use of enhanced PPE. Simulation training was performed in the simulation lab at the institution over 2 days. Pre and post self-evaluations were measured using standardized clinical competency questionnaires on a 5-point Likert Scale ranging from "No knowledge, unable to perform" up to "Highly knowledgeable and confident, independent."ResultsPhysicians self-reported a significant increase in knowledge and competency immediately after completing the training exercise. Resident physicians increased from a mean score of 3.00 to 4.67, p-value 0.0041, mean increase 1.67 (CI 95% 0.81 to 2.52). Attending physicians increased from a mean score of 2.89 to 4.67, p-value 0.0002, mean increase 1.78 (CI 95% 1.14 to 2.42). Overall, all participants increased from a mean score of 3.06 to 4.71, p-value 0.0001, mean increase 1.65 (CI 95% 1.24 to 2.05).DiscussionImplementation of this simulation training at our institution resulted in a significant increase in physician confidence regarding the safe performance of tracheostomy surgery in COVID-19 patients.Implications For PracticeAdoption of standardized COVID-19 tracheostomy simulation training at centers treating COVID-19 patients may result in improved physician safety and enhanced confidence in anticipation of performing these procedures in real-life scenarios.Copyright © 2020 Elsevier Inc. All rights reserved.

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