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Simulation-based training in advanced airway skills in an otolaryngology residency program


  • Milan R. Amin MD,

    Corresponding author
    1. Department of Otolaryngology, New York University School of Medicine, New York, New York, U.S.A.
    • Director of NYU Voice Center, Associate Professor of Otolaryngology, NYU School of Medicine, 345 East 37th Street, Suite 306, New York, NY 10016
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  • David R. Friedmann MD

    1. Department of Otolaryngology, New York University School of Medicine, New York, New York, U.S.A.
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  • Presented as a podium presentation at the Triological Society Spring Meeting at COSM, San Diego, California, U.S.A., April 21, 2012.

  • This study was funded in part by an intramural grant from the New York University School of Medicine Program for Medical Education Innovations and Research (awarded to M.R.A.). The authors have no other funding, financial relationships, or conflicts of interest to disclose.



Life-support training emphasizes the primacy of airway management. Acquiring these skills requires practice and exposure to events. Otolaryngology residents lack standardized training in advanced airway skills. This project aimed to create such a program by using simulation-based methodology evaluated using specific educationally based tools.

Study Design:

Prospective cohort study.


The program consisted of lectures and simulation-based training sessions designed to impart competency in a set of defined airway skills to otolaryngology residents. Only participating residents who completed the course (n = 12) were evaluated both before and after the course for their fund of knowledge through multiple-choice examinations and for clinical reasoning and technical skills as assessed by a panel of otolaryngologists in simulated difficult airway situations. Self-assessment tools were also incorporated.


The average multiple choice score was 12 of 27 (44%) before the course and 15 of 27 (55%) after the completion of the course (P = .001). Faculty assessment yielded a cumulative score of 80% and 91% pre- and postcourse, respectively (P = .002). Although all residents reported prior experience in a critical emergency airway situation, only one reported prior training in advanced airway skills. A significant increase in participants' self-perceived ability to carry out critical airway-related skills was observed. All respondents felt the course was effective.


Simulation-based airway training courses can be effectively incorporated into existing educational curricula for otolaryngology residents, and their success can be measured using educationally based tools. With such a course, residents can be expected to demonstrate measurable improvement in clinical knowledge base, technical skills, and self-perceived ability to handle difficult airway situations. Laryngoscope, 2013