A hierarchical task analysis of cricothyroidotomy procedure for a virtual airway skills trainer simulator

Doga Demirel, Kathryn L. Butler, Tansel Halic, Ganesh Sankaranarayanan, David Spindler, Caroline Cao, Emil Petrusa, Marcos Molina, Daniel B. Jones, Suvranu De, Marc A. deMoya

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background Despite the critical importance of cricothyroidotomy (CCT) for patient in extremis, clinical experience with CCT is infrequent, and current training tools are inadequate. The long-term goal is to develop a virtual airway skills trainer that requires a thorough task analysis to determine the critical procedural steps, learning metrics, and parameters for assessment. Methods Hierarchical task analysis is performed to describe major tasks and subtasks for CCT. A rubric for performance scoring for each task was derived, and possible operative errors were identified. Results Time series analyses for 7 CCT videos were performed with 3 different observers. According to Pearson's correlation tests, 3 of the 7 major tasks had a strong correlation between their task times and performance scores. Conclusions The task analysis forms the core of a proposed virtual CCT simulator, and highlights links between performance time and accuracy when teaching individual surgical steps of the procedure.

Original languageEnglish (US)
Pages (from-to)475-484
Number of pages10
JournalAmerican journal of surgery
Issue number3
StatePublished - Sep 1 2016

Bibliographical note

Funding Information:
Authors would like to thank Adam Ryason and Alexander Yu for their contributions in the study. This project was supported by National Institutes of Health (NIH) Grant NIH/NHLBI 1R01HL119248-01A1 , NIH/NIBIB 2R01EB005807 , 5R01EB010037 , 1R01EB009362 , and 1R01EB014305 .

Publisher Copyright:
© 2015 Elsevier Inc.


  • Cricothyroidotomy
  • Cricothyroidotomy simulator
  • Surgical education
  • Surgical simulator


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