Teaching Tracheostomy Management Using VoiceThread: Reflection on the evolution of our blended coaching approach

Developing pediatric resident trainees' proficiency in managing and troubleshooting tracheostomy issues is critical for the intensive care of children with medical complexity. Tracheostomy management, involving a set of complex technical and non-technical skills, are traditionally taught in simulation centers. The COVID pandemic, however, has posed a challenge to our in-person coaching, prompting us to explore the innovative use of VoiceThread to teach these skills using a blended approach. In this paper, we report the evolution from VoiceThread-based completely asynchronous coaching towards blended coaching, and we discuss the optimization of blended coaching into Just-in-Time Coaching. We demonstrate that the development of instructional approach was based on our critical analysis of different modes of teaching, reflection on lessons learned and best practices from implementation, and review of relevant literature. Our story can inform educators interested in leveraging the strengths of VoiceThread and different modes of coaching to enhance instruction with procedural skills training.