Simulation of Bleeding Airways in Cadavers: New Models for Experiential Learning

Background: Healthcare education models have recently shifted from the traditional reliance on the apprenticeship model, where trainees learn on real patients in actual clinical settings, to one based on simulation models. Education in airway management is a fundamental component of anesthetic training programs, and airway modification to simulate difficult airways increases the fidelity of airway management training. Objective: The study goal was to determine the feasibility of simulating difficult airways such as mandibular fracture and post-tonsillectomy bleed in cadaver models by surgical modification for the use in enhanced experiential learning of difficult airway management. Methods: Two cadaver heads were modified surgically to simulate a mandibular fracture and post-tonsillectomy bleed. Workshop facilitators conducted directed one-to-one learning and provided feedback to participants. A paper-based feedback was obtained from the participants on their confidence level, and the realism, attractiveness, beneficial levels, and difficulty levels of the simulation models used. Results: The modified cadavers were reliable in simulating difficult airways. The majority of participants (83.3% for fractured mandible and 87.1% for post-tonsillectomy bleed) reported an increase in confidence level for management of the difficult airway after the experience with the modified cadavers, and found both models realistic, attractive, and beneficial for difficult airway training. Conclusions: Surgical modifications of cadavers to simulate difficult airways such as fractured mandible and post-tonsillectomy bleed may be incorporated into advanced airway management courses to enhance experiential learning.