2024 Scholars' Research Symposium Abstract: Rapid Cycle Deliberate Practice (RCDP) to Master Airway Intubation.

Abstract

Introduction: Simulation has become an integral part of health care education curricula that is used to teach a variety of topics, from emergency situations to physical diagnoses. Without further reinforcement, the skills learned through the simulation are subject to deterioration over time. Rapid Cycle Deliberate Practice (RCDP) is a teaching method that was developed to resist this deterioration and achieve mastery of skills. In RCDP, learners cycle through a series of high-intensity and fast-paced scenarios until performance mastery was achieved. The individualized feedback is optimized with a 2:1 learner: instructor ratio. The goal of RCDP is to ensure 100% competency and time-efficiency of learners' performances. This study examined two sub-types of RCDP-style teaching to determine retention after 6-months.

Methods: A two-day airway management course was conducted using RCDP to teach endotracheal intubation to second-year medical students using Medical Students as Simulations Educators (MSASE) as instructors. On Day 1, learners participated in 40-minute training sessions using a 2:1 ratio of learners to educators to practice intravenous induction into anesthesia and endotracheal intubation. Half the groups used an immediate-feedback (IF) RCDP approach while the other half used a delayed-feedback (DF) RCDP approach. Day 2 was completed 1 week later using similar methods. Learners participated in a 1-day simulation course in 6 months to assess retention (Day 3).

Results: On Day 1, the IF group achieved mastery in fewer trials compared to the DF group (p = 0.004). The DF group required an average of 1.14 (CI = 0.845 - 1.433) trials until mastery, while the IF group required 0.516 (CI = 0.226 - 0.806) trials. The IF and DF groups demonstrated 98% knowledge and skills proficiency on Day 3, which is a significant increase from Day 1 and Day 2 scores of 92% and 88%, respectively. There was no significant difference in retention between the IF and DF groups.

Conclusions: RCDP is an effective teaching method to achieve mastery with performing endotracheal intubation to second-year medical students. There was no significant difference between immediate-feedback and delayed-feedback when retention of this clinical skill was reassessed at 6 months.