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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Veröffentlicht in:Simulation in healthcare : journal of the Society for Medical Simulation Jg. 20; H. 5; S. 297
Hauptverfasser: Gilic, Fil, McGraw, Robert, Newbigging, Joseph, Blackmore, Elizabeth, Stacey, Matthew, Mercer, Colin, Neufeld, Troy, Johannessen, Erika, Lam, Wilson, Hall, Ryan, Braund, Heather
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 01.10.2025
Schlagworte:
Airway Management - methods
Airway Management - standards
Clinical Competence
Cognition
Educational Measurement
Female
Humans
Interviews as Topic
Male
Pilot Projects
Simulation Training - organization & administration
evaluation
mixed methods
Airway
instructional design
ISSN:1559-713X, 1559-713X
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Abstract 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.
AbstractList 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.
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.INTRODUCTIONWe 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.METHODSWe 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.RESULTSMean 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.CONCLUSIONSAll 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.
Author Lam, Wilson
Hall, Ryan
Blackmore, Elizabeth
Braund, Heather
Stacey, Matthew
Gilic, Fil
Neufeld, Troy
Newbigging, Joseph
McGraw, Robert
Mercer, Colin
Johannessen, Erika
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  organization: From the Queen's University Department of Family and Emergency Medicine (F.G., J.N., E.B., M.S.); Queen's University Department of Emergency Medicine (R.M., C.M.); Queen's University Department of Family Medicine (T.N.); Queen's School of Medicine (E.J.); University of Ottawa Department of Emergency Medicine (W.L.); Quinte Health Care (R.H.); and Office of Professional Development and Educational Scholarship, Faculty of Health Sciences (H.B.), Queen's University, Kingston, Ontario, Canada
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StartPage 297
SubjectTerms Airway Management - methods
Airway Management - standards
Clinical Competence
Cognition
Educational Measurement
Female
Humans
Interviews as Topic
Male
Pilot Projects
Simulation Training - organization & administration
Title Achieving Reliable Mastery of Emergency Airway Management Skills Through 4-Component Instructional Design: A Mixed Methods Pilot Evaluation
URI https://www.ncbi.nlm.nih.gov/pubmed/39960375
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