{"pk":12992,"title":"Teaching Endotracheal Intubation Using a Cadaver Versus a Manikin-based Model: a Randomized Controlled Trial","subtitle":null,"abstract":"Introduction:\n 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 simulationmanikin.\nMethods:\n Fourth-year medical students, stratified by baseline ETI experience, were randomized 1:1to train on a cadaver or simulation manikin. Students were tested and video recorded on a separatecadaver; two reviewers, blinded to the intervention, assessed the videos. Primary outcome wastime to successful ETI, analyzed with a Cox proportional hazards model. Authors also comparedpercentage of glottic opening (POGO), number of ETI attempts, learner confidence, and satisfaction.\nResults: \nOf 97 students randomized, 78 were included in the final analysis. Median time to ETI didnot 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”) demonstrateddecreased time to ETI (HR = 4.2; 95% CI, 1.0-17.2).\nConclusion: \nManikin and cadaver training models for ETI produced similar time to ETI, POGO,and first-pass success. Cadaver training was associated with increased student satisfaction andconfidence; subjects with the highest confidence level demonstrated decreased time to ETI.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"education"},{"word":"intubation"}],"section":"Original Research","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0wn696m8","frozenauthors":[{"first_name":"Ryan","middle_name":"","last_name":"Pedigo","name_suffix":"","institution":"Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California\nLos Angeles Biomedical Research Institute, Torrance, California\nDavid Geffen School of Medicine at UCLA, Department of Emergency Medicine, Los\nAngeles, California","department":"None"},{"first_name":"Juliana","middle_name":"","last_name":"Tolles","name_suffix":"","institution":"Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California\nLos Angeles Biomedical Research Institute, Torrance, California\nDavid Geffen School of Medicine at UCLA, Department of Emergency Medicine, Los\nAngeles, California","department":"None"},{"first_name":"Daena","middle_name":"","last_name":"Watcha","name_suffix":"","institution":"Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California\nLos Angeles Biomedical Research Institute, Torrance, California","department":"None"},{"first_name":"Amy","middle_name":"H.","last_name":"Kaji","name_suffix":"","institution":"Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California\nLos Angeles Biomedical Research Institute, Torrance, California\nDavid Geffen School of Medicine at UCLA, Department of Emergency Medicine, Los\nAngeles, California","department":"None"},{"first_name":"Roger","middle_name":"J.","last_name":"Lewis","name_suffix":"","institution":"Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California\nLos Angeles Biomedical Research Institute, Torrance, California\nDavid Geffen School of Medicine at UCLA, Department of Emergency Medicine, Los\nAngeles, California","department":"None"},{"first_name":"Elena","middle_name":"","last_name":"Stark","name_suffix":"","institution":"David Geffen School of Medicine at UCLA, Department of Pathology and Laboratory\nMedicine, Los Angeles, California","department":"None"},{"first_name":"Jaime","middle_name":"","last_name":"Jordan","name_suffix":"","institution":"Los Angeles Biomedical Research Institute, Torrance, California\nDavid Geffen School of Medicine at UCLA, Department of Emergency Medicine, Los\nAngeles, California\nUCLA Ronald Reagan Medical Center, Department of Emergency Medicine, Los\nAngeles, California","department":"None"}],"date_submitted":"2019-07-15T23:06:30+02:00","date_accepted":"2019-07-15T23:06:30+02:00","date_published":"2019-12-10T00:07:36+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12992/galley/6808/download/"}]}