Tracheostomy management skills competency in physical medicine and rehabilitation residents: a method for development and assessment.

This educational unit was developed to instruct physical medicine and rehabilitation residents on tracheostomy management in non-ventilator-dependent patients and to implement an objective assessment format to measure the attainment of these skills. Thirty-one subjects participated in a 2-day didactic and hands-on workshop supervised by an attending physiatrist, certified speech pathologists, and registered nurses. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education. To test the success of the standardized educational module, data have been collected on an ongoing basis for a period of 6 yrs. A before-and-after multiple-choice written examination, as well as simulated patient encounters consisting of eight segments divided into four stations, was used to assess knowledge acquisition and skill achievement. Before instruction, none of the 31 participants were able to perform appropriate tracheostomy care. After the workshop, 31 of 31 (100%) successfully demonstrated clinical proficiency in every segment of the evaluation element of the educational module. Furthermore, a significant increase in knowledge was observed in the multiple-choice examination from pretest to posttest (pretest, 52.7%; posttest, 84.5%). Participation in this module resulted in substantial acquisition of knowledge and skills regarding tracheostomy management for physical medicine and rehabilitation residents.