Using the predictive model of difficult endotracheal intubation to examine different simulators for airway management training: a pilot cross-sectional observational study

Abstract Background In recent years, Taiwan’s medical education has increasingly emphasized simulated learning, particularly through advanced manikins designed for procedural training, including endotracheal intubation. Although key indicators and predictive techniques for assessing complexity have...

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Main Authors: Ching-Hsiang Yu, En-Chih Liao, Yat-Pang Chau, Ming-Kun Huang, Ching-Yi Shen, Ding-Kuo Chien
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Medical Education
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Online Access:https://doi.org/10.1186/s12909-025-07413-2
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author Ching-Hsiang Yu
En-Chih Liao
Yat-Pang Chau
Ming-Kun Huang
Ching-Yi Shen
Ding-Kuo Chien
author_facet Ching-Hsiang Yu
En-Chih Liao
Yat-Pang Chau
Ming-Kun Huang
Ching-Yi Shen
Ding-Kuo Chien
author_sort Ching-Hsiang Yu
collection DOAJ
description Abstract Background In recent years, Taiwan’s medical education has increasingly emphasized simulated learning, particularly through advanced manikins designed for procedural training, including endotracheal intubation. Although key indicators and predictive techniques for assessing complexity have been documented, their use in evaluating these manikins remains notably lacking.The aim of this study was to appraise the potential association between our devised scoring system and the actual outcome of intubation procedures. Subsequently, this scoring system could potentially serve as an objective yardstick for quantifying the intricacy of training simulators. Methods Nineteen post-graduate or emergency medicine trainees participated in this study. Intubation training involved four manikins, each with varying difficulty scores based on neck circumference, thyromental distance, airway obstruction, and Mallampati grade 3/4. Training modules included standard, advanced, and small adult intubation. Independent variables were training models and operator skill levels, while dependent variables included intubation time, success rate, tooth injury, gastric insufflation, uninflated cuff mishaps, perceived difficulty (rated 1–5), and laryngoscopy view quality (rated 1–4). Results and discussion Intubation parameters were recorded for comparison across subgroups. Mean intubation times for models A, B, and D were 42.67 ± 15.32 seconds, 48.73 ± 17.54 seconds, and 50.22 ± 18.40 seconds, with success rates of 89.47%, 78.95%, and 68.42%, respectively. Model ‘C’ had the highest difficulty score (4.430 points), the longest intubation time (58.84 ± 22.63 seconds, P <.001), and the lowest success rate (57.89%, P <.001), and was rated most difficult by participants. Notably, subsequent intubation attempts showed reduced time and complexity compared to the initial one.In conclusions, our devised scoring metric demonstrated a remarkable congruence with the tangible outcomes of the challenging endotracheal intubation training model. This outcome lends credence to the potential applicability of our formula not only in assessing the intricacy of existing models but also as a guiding benchmark for the innovation and refinement of novel training manikins.
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spelling doaj-art-b0d2c77f9af6422699294ded73b0ca572025-08-20T02:05:41ZengBMCBMC Medical Education1472-69202025-06-0125111010.1186/s12909-025-07413-2Using the predictive model of difficult endotracheal intubation to examine different simulators for airway management training: a pilot cross-sectional observational studyChing-Hsiang Yu0En-Chih Liao1Yat-Pang Chau2Ming-Kun Huang3Ching-Yi Shen4Ding-Kuo Chien5Department of Emergency Medicine, MacKay Memorial HospitalDepartment of Medicine, MacKay Medical CollegeDepartment of Medicine, MacKay Medical CollegeDepartment of Emergency Medicine, MacKay Memorial HospitalDepartment of Emergency Medicine, MacKay Memorial HospitalDepartment of Emergency Medicine, MacKay Memorial HospitalAbstract Background In recent years, Taiwan’s medical education has increasingly emphasized simulated learning, particularly through advanced manikins designed for procedural training, including endotracheal intubation. Although key indicators and predictive techniques for assessing complexity have been documented, their use in evaluating these manikins remains notably lacking.The aim of this study was to appraise the potential association between our devised scoring system and the actual outcome of intubation procedures. Subsequently, this scoring system could potentially serve as an objective yardstick for quantifying the intricacy of training simulators. Methods Nineteen post-graduate or emergency medicine trainees participated in this study. Intubation training involved four manikins, each with varying difficulty scores based on neck circumference, thyromental distance, airway obstruction, and Mallampati grade 3/4. Training modules included standard, advanced, and small adult intubation. Independent variables were training models and operator skill levels, while dependent variables included intubation time, success rate, tooth injury, gastric insufflation, uninflated cuff mishaps, perceived difficulty (rated 1–5), and laryngoscopy view quality (rated 1–4). Results and discussion Intubation parameters were recorded for comparison across subgroups. Mean intubation times for models A, B, and D were 42.67 ± 15.32 seconds, 48.73 ± 17.54 seconds, and 50.22 ± 18.40 seconds, with success rates of 89.47%, 78.95%, and 68.42%, respectively. Model ‘C’ had the highest difficulty score (4.430 points), the longest intubation time (58.84 ± 22.63 seconds, P <.001), and the lowest success rate (57.89%, P <.001), and was rated most difficult by participants. Notably, subsequent intubation attempts showed reduced time and complexity compared to the initial one.In conclusions, our devised scoring metric demonstrated a remarkable congruence with the tangible outcomes of the challenging endotracheal intubation training model. This outcome lends credence to the potential applicability of our formula not only in assessing the intricacy of existing models but also as a guiding benchmark for the innovation and refinement of novel training manikins.https://doi.org/10.1186/s12909-025-07413-2Difficult endotracheal intubationEmergency departmentMedical educationTraining modelSimulatorManikin
spellingShingle Ching-Hsiang Yu
En-Chih Liao
Yat-Pang Chau
Ming-Kun Huang
Ching-Yi Shen
Ding-Kuo Chien
Using the predictive model of difficult endotracheal intubation to examine different simulators for airway management training: a pilot cross-sectional observational study
BMC Medical Education
Difficult endotracheal intubation
Emergency department
Medical education
Training model
Simulator
Manikin
title Using the predictive model of difficult endotracheal intubation to examine different simulators for airway management training: a pilot cross-sectional observational study
title_full Using the predictive model of difficult endotracheal intubation to examine different simulators for airway management training: a pilot cross-sectional observational study
title_fullStr Using the predictive model of difficult endotracheal intubation to examine different simulators for airway management training: a pilot cross-sectional observational study
title_full_unstemmed Using the predictive model of difficult endotracheal intubation to examine different simulators for airway management training: a pilot cross-sectional observational study
title_short Using the predictive model of difficult endotracheal intubation to examine different simulators for airway management training: a pilot cross-sectional observational study
title_sort using the predictive model of difficult endotracheal intubation to examine different simulators for airway management training a pilot cross sectional observational study
topic Difficult endotracheal intubation
Emergency department
Medical education
Training model
Simulator
Manikin
url https://doi.org/10.1186/s12909-025-07413-2
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