RESUMO
BACKGROUND: Similar to other sub-Saharan countries, Ethiopia suffers from a severe shortage of adequately trained health professionals. Academic partnerships can support sustainable training programs and build capacity for low-resource settings. 3D modeling and simulation-based training provide necessary tools, especially for rarely-encountered clinical situations, such as needle cricothyroidotomy. METHODS: Departments of Anesthesiology, Otolaryngology, and Learning Health Sciences collaborated to develop a low-cost, high-fidelity simulator and Cricothryoidotomy Skills Maintenance Program (CSMP). Twelve anesthesia residents at St. Paul's Hospital Medical Millennium College in Addis Ababa, Ethiopia participated in CSMP. The program consisted of a didactic session with presentation and demonstration and an immersive CICO scenario. Program evaluation was performed using pre/post-training knowledge and 2 procedural performance assessments-the CSMP Global Rating Scale and the Checklist. With consent, performances were videotaped and rated independently by 3 University of Michigan faculty. RESULTS: Improvements were identified in all areas, including residents' knowledge, measured by mean summed test scores (Mpreâ¯=â¯3.31,Mpostâ¯=â¯4.46,pâ¯=â¯0.003), time to perform cricothyroidotomy (Mpreâ¯=â¯96.64,Mpostâ¯=â¯72.82,pâ¯=â¯0.12), residents' performance quality, measured by overall mean Global ratings, (Mpreâ¯=â¯0.20; Mpostâ¯=â¯0.70) with improvements identified at the item-level, pâ¯=â¯0.001 with moderate-large effect sizes, and residents' ability to complete tasks, measured by mean Checklist ratings (Mpreâ¯=â¯0.51,Mpostâ¯=â¯0.90, with item-level improvements observed, pâ¯≤â¯0.01, with small-large effect sizes. Residents' self-reported confidence also improved (Mpreâ¯=â¯1.69, Mpostâ¯=â¯3.08,pâ¯=â¯0.001). CONCLUSION: Our work shows that cricothyroidotomy skills taught to anesthesia residents at SPHMMC with a 3D printed laryngotracheal model improves knowledge, skills, and confidence. The creation of a low-cost, high-fidelity simulator and a CSMP has the potential to impact patient care and safety world-wide.