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Teaching Endotracheal Intubation Using a Cadaver Versus a Manikin-based Model: a Randomized Controlled Trial.
Pedigo, Ryan; Tolles, Juliana; Watcha, Daena; Kaji, Amy H; Lewis, Roger J; Stark, Elena; Jordan, Jaime.
Afiliación
  • Pedigo R; Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California.
  • Tolles J; Los Angeles Biomedical Research Institute, Torrance, California.
  • Watcha D; David Geffen School of Medicine at UCLA, Department of Emergency Medicine, Los Angeles, California.
  • Kaji AH; Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California.
  • Lewis RJ; Los Angeles Biomedical Research Institute, Torrance, California.
  • Stark E; David Geffen School of Medicine at UCLA, Department of Emergency Medicine, Los Angeles, California.
  • Jordan J; Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California.
West J Emerg Med ; 21(1): 108-114, 2019 Dec 09.
Article en En | MEDLINE | ID: mdl-31913829
INTRODUCTION: The optimal method to train novice learners to perform endotracheal intubation (ETI) is unknown. The study objective was to compare two models: unembalmed cadaver vs simulation manikin. METHODS: Fourth-year medical students, stratified by baseline ETI experience, were randomized 1:1 to train on a cadaver or simulation manikin. Students were tested and video recorded on a separate cadaver; two reviewers, blinded to the intervention, assessed the videos. Primary outcome was time to successful ETI, analyzed with a Cox proportional hazards model. Authors also compared percentage of glottic opening (POGO), number of ETI attempts, learner confidence, and satisfaction. RESULTS: Of 97 students randomized, 78 were included in the final analysis. Median time to ETI did not differ significantly (hazard ratio [HR] 1.1; 95% CI [confidence interval], 0.7-1.8): cadaver group = 34.5 seconds (interquartile ratio [IQR]: 23.3-55.8) vs manikin group = 35.5 seconds (IQR: 23.8-80.5), with no difference in first-pass success (odds ratio [OR] = 1; 95% CI, 0.1-7.5) or median POGO: 80% cadaver vs 90% manikin (95% CI, -14-34%). Satisfaction was higher for cadavers (median difference = 0.5; p = 0.002; 95% CI, 0-1) as was change in student confidence (median difference = 0.5; p = 0.03; 95% CI, 0-1). Students rating their confidence a 5 ("extremely confident") demonstrated decreased time to ETI (HR = 4.2; 95% CI, 1.0-17.2). CONCLUSION: Manikin and cadaver training models for ETI produced similar time to ETI, POGO, and first-pass success. Cadaver training was associated with increased student satisfaction and confidence; subjects with the highest confidence level demonstrated decreased time to ETI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enseñanza / Educación de Pregrado en Medicina / Intubación Intratraqueal Tipo de estudio: Clinical_trials / Observational_studies Límite: Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: West J Emerg Med Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enseñanza / Educación de Pregrado en Medicina / Intubación Intratraqueal Tipo de estudio: Clinical_trials / Observational_studies Límite: Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: West J Emerg Med Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos