Development and implementation of a two-part curriculum for cricothyroidotomy using individual cadaveric simulation for senior surgical residents

Abstract Purpose Cricothyroidotomy—emergent breathing tube placement through the cricothyroid membrane—is required for patients who are not oxygenating and cannot be ventilated. We sought to develop and implement a curriculum for residents to address the technical, cognitive, and emotional components of this low-frequency, high-stakes procedure. Methods We developed a two-component emergency airway curriculum using Kern’s 6 step approach, which was delivered to general surgery and neurosurgery residents in Spring 2024 (Cohort 1) and Spring 2025 (Cohort 2). The first component was a didactic session about the indications and procedural steps. The second component was an individual cadaveric simulation with confederates playing the roles of the patient’s family member and the patient’s nurse. Participants completed pre-course demographics and confidence surveys. Performance in cadaveric simulation was assessed by faculty. Participants in Cohort 1 completed a one-year post-course survey to assess Kirkpatrick level four effectiveness. Results Forty residents participated (20 male (50%); 26 White (67%); 28 General Surgery (70%); 12 Neurosurgery (30%)). All learners achieved competency on the first attempt with an average cricothyroidotomy time of 1 minute and 28 seconds (± 48 seconds). The one-year post-course survey showed that half of participants performed at least one cricothyroidotomy subsequently. In all cases, the airway was successfully established. Nearly all (80%) who performed a cricothyroidotomy reported that the course was helpful in preparing them. Conclusions We instituted a successful, two-part emergency airway curriculum in which all learners achieved competency. After implementation, nine successful emergency airways were performed one year afterwards, suggesting clinical effectiveness.