Remote Simulation as a Training Method for Artificial Airway Suctioning Technique

Artificial airway suctioning is a complex and high-risk procedure that requires adequate training before clinical exposure. Remote simulation has emerged as an alternative educational strategy; however, evidence regarding its impact on procedural competence and related learning domains remains limited.

A quasi-experimental study was conducted with 4th-year physiotherapy students enrolled in a cardiorespiratory course. Participants completed a 4-week asynchronous remote simulation program that included instructional materials, practice on a low-fidelity 3D airway model, and individualized multimodal feedback. Procedural performance was assessed using Directly Observed Procedural Skills (DOPS) and compared with expert performance. Theoretical knowledge, anxiety levels, and students' perceptions were also evaluated. Psychometric analyses were performed for the theoretical test and perception questionnaire.

Fifty-six students completed the program. Procedural performance improved significantly across training sessions (P < .001), with students achieving DOPS scores comparable with expert performance under standardized assessment conditions. No statistically significant changes were observed in theoretical knowledge or anxiety levels. Theoretical test analysis showed acceptable internal consistency and evidence of ceiling effects. Students reported positive perceptions of the training experience, and the perception questionnaire demonstrated high internal consistency and a predominantly unidimensional structure.

Asynchronous remote simulation was associated with improvements in procedural performance and positive learning perceptions in physiotherapy students. These findings support remote simulation as a feasible strategy for competency-based training while highlighting the importance of appropriate assessment tools and contextual interpretation of outcomes.