Ishan Perera

Abstract

We are investigating the impact of a standardized training procedure with distinct focuses on Direct Laryngoscopy (DL), Indirect Video Laryngoscopy (IVL), and Direct Video Laryngoscopy (DVL) on trainees’ proficiency in performing the direct laryngoscopy technique with confidence. Previous studies have indicated that DL training, when compared to Video Laryngoscopy (VL) training, resulted in faster intubation times. Conversely, another study demonstrated that using a videolaryngoscope in both direct and indirect manners led to quicker DL times. This study aims to compare various training methods and assess performance outcomes based on metrics such as successful intubation, time to successful intubation, incidence of dental injury, and Numeric Rating Score (NRS) to gauge trainee self-perception and the trainee’s confidence level in performing intubation for future real-life scenarios. Our results indicate no statistical significance among modalities based on outcomes assessed through ANOVA and Tukey Contrast Tests. This suggests that observed differences lack statistical evidence for genuine distinction, potentially stemming from random variation. However, a nuanced analysis reveals that the effects of these modalities are not mutually exclusive, indicating a complex interplay of factors beyond modality selection. Upon stratifying data to exclude participants with prior intubation experience, video-based modalities exhibited a 100% positive difference in successful intubations, outperforming the Direct modality, which showed a 57% positive difference. Dental injury analysis yielded the greatest reduction in the DVL cohort. Additionally, DVL demonstrated the quickest time to intubation during post-assessment at 60 seconds, 21 seconds faster than IVL and 29 seconds faster than DL. NRS of participant self perception demonstrated the smallest average difference from post to pre-assessment in the DVL cohort, with the greatest difference seen in the IVL group. NRS of participant confidence in performing intubation in a real-world intubation demonstrated the largest average difference within the DVL cohort from pre to post-assessment, with the smallest difference in the DL cohort. While statistical significance may elude the disparities among modalities, discerned patterns suggest a noteworthy efficacy of video-based approaches. These findings lay the groundwork for future studies to delve deeper into the role of video-based educational modalities in medical education and curriculum.

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