Cricothyrotomy Simulator with Computational Skill Assessment for Procedural Skill Training in the Developing World

Abstract

Objectives: Cricothyrotomy is a life-saving procedure performed when an airway cannot be established through less invasive techniques. The goals of this study were to 1) design and build a low-cost simulator that teaches essential anatomy, and 2) provide a method of data collection for performance evaluation and guided instruction. Methods: The design of the simulator was optimized for materials that are low-cost and widely available and for accurate anatomical landmarks. It was designed to electronically record instrument contact with critical anatomical locations throughout the procedure. Three simulators were constructed, and data were collected during 20 procedures performed by participants of varying surgical experience level. Surveys were completed by all participants to assess the perceived quality of the simulator. Three experts graded the recorded procedures by completing an Objective Structured Assessment of Technical Skills (OSATS) survey. Results: A simulator was designed and built. Procedural data of 20 subjects were collected. The survey data showed the majority of participants answered “moderate” or “very” on questions related to 1) anatomical accuracy (85%), 2) realism (50%), 3) improved understanding of procedure (65%), and 4) useful for practice (85%). The OSATS data correlated with task time. Conclusions: A cricothyrotomy simulator for use in a low-resource environment was designed and produced. It collects data that can be used for performance evaluation and instruction. These were analyzed against OSATS data. A study of 20 subjects, 12 of whom were experts, demonstrated that it was realistic, anatomically accurate, and useful for practice and improving procedure knowledge.