Achieving Reliable Mastery of Emergency Airway Management Skills Through 4-Component Instructional Design: A Mixed Methods Pilot Evaluation

We used cognitive load theory to design the Queen's University Airway Mastery (QUMAC) pilot course to work toward reliable mastery of Emergency Airways Management elements in all participants. We describe the process of designing QUMAC using 4-Component Instructional Design to harness the cogni...

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Vydáno v:Simulation in healthcare : journal of the Society for Medical Simulation Ročník 20; číslo 5; s. 297
Hlavní autoři: Gilic, Fil, McGraw, Robert, Newbigging, Joseph, Blackmore, Elizabeth, Stacey, Matthew, Mercer, Colin, Neufeld, Troy, Johannessen, Erika, Lam, Wilson, Hall, Ryan, Braund, Heather
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.10.2025
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ISSN:1559-713X, 1559-713X
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Shrnutí:We used cognitive load theory to design the Queen's University Airway Mastery (QUMAC) pilot course to work toward reliable mastery of Emergency Airways Management elements in all participants. We describe the process of designing QUMAC using 4-Component Instructional Design to harness the cognitive load theory as a learning tool. We evaluated the effectiveness of QUMAC using an outcome-based mixed-methods approach including Objective Structured Assessment of Technical Skills (OSATS) and 2 Objective Structured Clinical Examinations (OSCEs) at course completion using blinded expert video review. We also conducted semistructured interviews at course completion and after 6 months of independent practice. Interviews were analyzed thematically. Mean OSCE Global Performance Scores were 4.1 (±0.56) of 5 for both OSCE scores; and 4.0-4.4 (±0.48-0.89) on OSATS. At course completion, 4 themes were identified: Overall Experience with the Course, Facilitators of Performance, Recommendations, and Transfer to Practice. At 6 months of independent practice 5 themes emerged: Level of Confidence, Management of Cognitive Load, Persistence, Barriers to Application, and Recommendations. All participants demonstrated a high degree of competence when assessed by OSCEs and majority did so with the OSATS. All noticed an increase in confidence and reduced cognitive load while managing airways. These persisted over 6 months of independent practice where the participants were actively managing airways as staff physicians in new workplaces. High performance expectations, automation, schemas, spaced repetition, and homework were the elements most associated with better performance and more confidence. Decreased cognitive load freed up resources for higher order thinking, while the overall sense of competence reduced the anxiety of going to work as a new emergency department staff.
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ISSN:1559-713X
1559-713X
DOI:10.1097/SIH.0000000000000847