Teaching Endotracheal Intubation Using a Cadaver Versus a Manikin-based Model: a Randomized Controlled Trial

Area of Science:

• Medical Education
• Emergency Medicine
• Anesthesiology

Background:

• Optimal training methods for endotracheal intubation (ETI) in novice learners remain unclear.
• This study compared unembalmed cadavers and simulation manikins as ETI training models.

Purpose of the Study:

• To compare the effectiveness of cadaver versus manikin training models for endotracheal intubation (ETI).
• To assess outcomes including time to successful ETI, glottic opening visualization, first-pass success, learner confidence, and satisfaction.

Main Methods:

• Fourth-year medical students were randomized to train on either a cadaver or a simulation manikin.
• Performance was assessed via video recording on a separate cadaver, with blinded reviewers evaluating time to ETI, percentage of glottic opening (POGO), and first-pass success.
• Learner confidence and satisfaction were also measured.

Main Results:

• No significant difference was found in median time to successful ETI between the cadaver and manikin groups (HR 1.1; 95% CI, 0.7-1.8).
• First-pass success and median POGO also showed no significant differences.
• Cadaver training resulted in higher student satisfaction (p = 0.002) and increased confidence (p = 0.03).
• Students reporting "extremely confident" demonstrated significantly decreased time to ETI (HR = 4.2; 95% CI, 1.0-17.2).

Conclusions:

• Both manikin and cadaver models for ETI training result in comparable procedural success and efficiency.
• Cadaver training is associated with superior learner satisfaction and confidence.
• Higher learner confidence correlates with improved ETI performance, suggesting a potential benefit beyond technical skill acquisition.