Three decades before, Ovassapian initiated a structured training program for teaching of flexible fiberoptic tracheal intubation and airway evaluation, primarily intended for anesthesia residents (20). This program provided formal training on airway models for acquisition of sufficient manipulation skills and instructor supervision during the first series of practice on patients until obtaining acceptable technical performance and clinical competence. For training of anesthetists from other departments and dissemination of endoscopic skills into their clinical practice, he organized hands-on workshops offering instruction and practice on airway models.
Comparable training programs should be standard for all airway devices and techniques (5, 9). Unfortunately, training on airway models is still underused during anesthesia residency training (13, 16) and only few institutions have a structured training program, for example dedicated rotations for advanced airway management (AM) techniques supervised by experienced instructors, as evaluated by recently published survey questionnaires (8, 10, 13). Therefore it is not surprising that anesthesia residents lack special knowledge and practical skills in handling the difficult airway (DA) (17).
The results of a survey questionnaire in regard to teaching and training of anesthesia residents in AM, including all anesthesia departments in Austria (18), were considered by our working group to formulate these recommendations. We studied published guidelines and recommendations for DA management; furthermore, we reviewed the current literature with emphasis on teaching and training of AM techniques. Based on these reviews and available evidence, we generated these recommendations in order to assist the Austrian anesthesia community in formulating departmental directives. The nationwide implementation of structured teaching and training programs for anesthesia residents with a stepwise approach from basic practices to advanced techniques providing initial training on airway models and then dedicated airway rotations in clinical practice followed by regular training of advanced AM techniques throughout the remainder of their residency training and the provision of continued training of advanced AM techniques for all staff anesthesists may improve patient care and prevent adverse outcomes associated with DA management.
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