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Enhancing self-efficacy for emergency cricothyrotomy through simulation-based training in CICO scenarios
Dissertation   Open access

Enhancing self-efficacy for emergency cricothyrotomy through simulation-based training in CICO scenarios

Steven Faust and Kaycee Johnson
Doctor of Nursing Practice (D.N.P.), Drexel University
15 Mar 2026
DOI:
https://doi.org/10.17918/00011290
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Abstract

Simulation-based education Cricothyrotomy Self-efficacy Nurse anesthesia education Airway management
Emergency cricothyrotomy is a rare but critical intervention required during a "cannot intubate, cannot oxygenate" airway emergencies; however, many anesthesia providers lack confidence in performing this high-acuity, low-frequency procedure. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the effectiveness of a structured, simulation-based educational intervention on self-efficacy and confidence among Student Registered Nurse Anesthetists. A pre-post intervention design was implemented in a high-fidelity academic simulation laboratory with 17 Student Registered Nurse Anesthetists. The intervention included a didactic presentation, instructional video, and hands-on simulation using anatomically realistic airway models. Self-efficacy was measured using surveys adapted from Bandura's self-efficacy framework, utilizing a continuous 0-100 numeric confidence scale across four procedural domains. Due to technical limitations and violations of normality assumptions, Mann-Whitney U tests were used to compare pre- and post-intervention groups. Statistically significant improvements were observed across all measured domains (p < 0.001). These findings support simulation-based education as an effective strategy to enhance provider confidence and preparedness for emergency surgical airway management.

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