Avaliação e treinamento em ambiente simulado de estudantes de medicina da UFRN sobre a técnica de intubação orotraqueal

Abstract

INTRODUCTION: Orotracheal intubation (OTI) is characterized by an invasive procedure, exclusive to the medical professional, in which a cannula is introduced into the trachea with the main objective of ensuring a definitive airway. With the emergence of the COVID-19 pandemic, the concern with the adequate mastery of the technique, especially by newly graduated physicians, became more evident. The procedure has numerous inherent risks and complications, which have high morbidity and mortality rates. The main way to reduce the risks associated with the procedure is through adequate and continuous training of medical professionals, improving the technical/practical part, in addition to preparing for the early identification and treatment of potential complications. An important teaching tool for the development of techniques like this is training in simulated environments, through practice stations, with checklists and feedback. OBJECTIVES: To evaluate and compare the theoreticalpractical knowledge of the students of the internship of the Medicine course at UFRN about OTI before and after the training in a simulated environment, in addition to proposing a structured training in IoT for the students at the beginning of the internship in Surgery and elaboration of a class guide. METHODS: 69 students from the tenth semester of the medical school at UFRN were evaluated on the OTI technique before and after a simulated training, with a practice station and checklist. A questionnaire was also applied, in the pre and post phases, about the content taught, the importance of the theme and the students' confidence in performing IOT. In the end, each student received individual feedback and the data were analyzed and compared, with statistical analysis. RESULTS AND DISCUSSION: After the training, there was a substantial improvement in the students' performance. In the pre-test, 30.4% of the students were classified as having unsatisfactory performance in the OTI technique against only 1.4% in the post-test. For the result considered higher than expected, this result jumped from 26.1% to 88.4%. In addition, it is inferred that there was a significant change in the pre- and post-test responses in relation to the success in performing the OTI among the students. In the pre-test, 68.2% of the students were successful and 31.8% were not. In the post-test, 89.9% of the students were successful in the technique, while only 10.1% were unsuccessful, with this change being statistically significant (p-value of 0.0013). We can also observe an increase in the confidence of the students to perform the procedure after the period of practice and training. CONCLUSIONS: Simulated practical instruction in the orotracheal intubation (OTI) technique is essential for the training of medical interns. The use of methodological approaches and simulators resulted in a notable increase in students' competence and self-confidence after the intervention. This form of approach, with the integration of simulators, is gaining increasing acceptance in the field of medical education. However, there is still a lack of more robust studies, especially at the national level, that can demonstrate the real advantage of this technique.