Validation of a low-cost simulation strategy for burn escharotomy training / Irene Y. Zhanga, Mark Thomas, Barclay T. Stewart, Eleanor Curtis, Carolyn Blayneya , Samuel P. Mandell, Vance Y. Sohnd, Tam N. Pham
Material type:
Continuing resourceISSN: 0020-1383Subject(s): Eschar | Escharotomy | Full-thickness | Third degree | Decompression | Compartment syndrome | Burn
In:
Injury -- 2020, v 51, p. 2059-2065Summary: Background: Escharotomy is the primary effective intervention to relieve constriction and impending vascular compromise in deep, circumferential or near-circumferential burns of the extremities and trunk.
Training on escharotomy indications, technique and pitfalls is essential, as escharotomy is both an infrequent and high-risk procedure in civilian and military medical environments, including low-resource
settings. Therefore, we aimed to validate an educational strategy that combines video-based instruction
with a low-cost, low-fidelity simulation model for teaching burn escharotomy.
Methods: Pre-hospital and hospital-based medical personnel, with varying degrees of burn care-related
experience, participated in a one-hour training session. The first part of the training consisted of videobased instruction that described the indications, preparation, steps, pitfalls and complications associated
with escharotomy. The second part of the training consisted of a supervised, hands-on simulation with a
previously described low-cost, low-fidelity escharotomy model. Participants were then offered two psychometrically validated instruments to assess their learning experience.
Results: 40 participants were grouped according to prior burn care and surgical experience: attending
surgeons (6), surgery and emergency medicine residents and fellows (26), medical students (5), and prehospital personnel (3). On two psychometrically validated questionnaires, participants at both the attending and trainee levels overwhelmingly confirmed that our educational strategy met best educational
practices on the criteria of active learning, collaboration, diverse ways of learning, and high expectations;
they also highly rated their satisfaction with and self-confidence under this learning strategy.
Discussion: An educational strategy that combines video-based instruction and a low-cost, low-fidelity
escharotomy simulation model was successfully demonstrated with participants across a broad range of
prior burn care experience levels. This strategy is easily reproducible and broadly applicable to increase
the knowledge and confidence of medical personnel before they are called to perform escharotomy. Important applications include resource-limited environments and deployed military setting
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Bibliografía: p.2065
Background: Escharotomy is the primary effective intervention to relieve constriction and impending vascular compromise in deep, circumferential or near-circumferential burns of the extremities and trunk.
Training on escharotomy indications, technique and pitfalls is essential, as escharotomy is both an infrequent and high-risk procedure in civilian and military medical environments, including low-resource
settings. Therefore, we aimed to validate an educational strategy that combines video-based instruction
with a low-cost, low-fidelity simulation model for teaching burn escharotomy.
Methods: Pre-hospital and hospital-based medical personnel, with varying degrees of burn care-related
experience, participated in a one-hour training session. The first part of the training consisted of videobased instruction that described the indications, preparation, steps, pitfalls and complications associated
with escharotomy. The second part of the training consisted of a supervised, hands-on simulation with a
previously described low-cost, low-fidelity escharotomy model. Participants were then offered two psychometrically validated instruments to assess their learning experience.
Results: 40 participants were grouped according to prior burn care and surgical experience: attending
surgeons (6), surgery and emergency medicine residents and fellows (26), medical students (5), and prehospital personnel (3). On two psychometrically validated questionnaires, participants at both the attending and trainee levels overwhelmingly confirmed that our educational strategy met best educational
practices on the criteria of active learning, collaboration, diverse ways of learning, and high expectations;
they also highly rated their satisfaction with and self-confidence under this learning strategy.
Discussion: An educational strategy that combines video-based instruction and a low-cost, low-fidelity
escharotomy simulation model was successfully demonstrated with participants across a broad range of
prior burn care experience levels. This strategy is easily reproducible and broadly applicable to increase
the knowledge and confidence of medical personnel before they are called to perform escharotomy. Important applications include resource-limited environments and deployed military setting
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