Assessing the Impact of a Training Initiative for Nasopharyngeal and Oropharyngeal Swabbing for COVID-19 Testing

Abstract

Objective The accuracy and reliability of COVID-19 testing are critical to limit transmission. After observing variability in testing techniques, we otolaryngologists at a tertiary medical center initiated and evaluated the impact of nasopharyngeal and oropharyngeal swabbing training, including video instruction, to standardize sampling techniques and ensure high-quality specimens. Methods Participants in the training were employees (N = 40). Training consisted of an instructional video on how to perform nasopharyngeal and oropharyngeal swabs and a live demonstration. Participants completed pre- and posttraining surveys assessing their knowledge and confidence in performing nasopharyngeal and oropharyngeal swabs. They then performed swabbing on partners, which was graded per a standardized checklist. Results Mean scores for knowledge-based questions and confidence in swabbing were significantly higher after the training session (both P < .001). All participants scored ≥6 of 8 on the posttraining checklist. Ninety-five percent rated the video as very or extremely useful. Discussion Specialized instruction for nasopharyngeal swabbing improved participants’ knowledge—specifically, the appropriate head position and minimum swab time in nasopharynx—and their confidence. After the training, their swabbing execution scores were high. Implications for Practice Video-assisted hands-on instruction for nasopharyngeal swab sampling can be used to standardize teaching. When prompt and accurate testing is paramount, this instruction can optimize procedural technique and should be used early and often. In addition, there may be a professional responsibility of otolaryngologists to participate in such initiatives.