84 It’s all about that trach - Episode II: Acceptability, accessibility, inclusivity and feasibility

Abstract Background Pediatric tracheostomy care is a vital but intimidating critical skill required of parents and pediatricians. Consistent caregiver training is vital to promote safety. An Alberta team is developing the “Tracheostomy Journey” to help caregivers navigate and communicate through caring for children with tracheostomy. A needs assessment identified consistent, universal multimodal teaching and communication tools for care providers as a primary need. Objectives The objective of this study was to evaluate “train the trainer” pediatric tracheostomy care modules for feasibility, acceptability, accessibility and inclusivity. Design/Methods This project evaluated goal-oriented training modules previously developed by the research team to provide simulation-based training to pediatric residents. The modules were adapted to fit the national residency curriculum requirements for CBD (Competency by Design). Pediatric residents participated in simulation with the modules, which were precepted by two simulation experts and a subspecialty fellow. Modules were offered to all trainees regardless of their choice to participate. Participants completed questionnaires before and after the session, rating their confidence and self-assessed competence, module accessibility, acceptability and inclusiveness and feedback for improvement. Preceptors reported their comfort and self-assessed competence teaching the module content and evaluated content, accessibility, acceptability and inclusiveness. Results All 25 General Pediatrics resident participants found the training effective. Pre- and post-workshop surveys showed the training increased confidence in caring for patients, and confidence and competence in various levels of involvement from supporting care to leading and teaching. Qualitative feedback on accessibility, acceptability, and inclusivity was positive. Preceptor evaluation suggested the “train the trainer” aspect was achieved. Conclusion Tracheostomy care simulation materials designed to meet CBD goals increased confidence and self-assessed competence for emergency care tasks. A “train the trainer” approach to module design provided subspecialty fellows with confidence using the modules to teach. This trial suggests that “train the trainer” module design is accessible and feasible for resident training programs. Trials with families and allied health caring for children with tracheostomy will be completed next. Universally adoptable “train the trainer” modules are proposed as a means to ensure uniform skill development to effectively deliver care to children with tracheostomy.