Evaluation of learning effectiveness in endotracheal intubation by the use of a laryngoscope in combination with a flexible fiberoptic bronchoscope.
BACKGROUND
Accidental esophageal intubation may cause lethal complications when undetected. We developed a laryngoscope, which utilizes a laryngoscope blade incorporating with a flexible fiberoptic bronchoscope for teaching new learners. We compared two teaching methods, i.e. the traditional method and the new method we contemplated, for teaching new interns.


METHODS
We selected new interns as our study group. Everyone had six turns, four of which for the traditional method (T) and two of which for the new method (N), to perform the procedure under the guidance of a teaching supervisor. The interns were assigned randomly to one of three groups. Group 1 used the series of TTTTNN; group 2, TTNNTT; and group 3, NNTTTT. We used success or failure of intubation as the result of our evaluation. Statistical analyses were performed by chi-square test.


RESULTS
84 interns performed 504 endotracheal intubation trials during a period of 4 years. There was a 91.7% success rate with the new method and a 78.9% success rate with the traditional technique (P < 0.05). The group to which the new method was initially taught achieved the highest success rate of intubation and the greatest feeling of satisfaction according to a self-evaluation record. Of the failed intubations, 82.4% were due to performing the procedure in more than one minute, 15.3% due to esophageal intubation and the remaining 2.3% due to contact bleeding of teeth or oral trauma.


CONCLUSIONS
By using the new teaching method, the supervisor could easily teach and assess the success of the new learners. Besides, esophageal intubation could be reduced to a minimum with subsequent increase of success rate.
Hung
W T
WT
Department of Anesthesiology, Chung Shan Medical and Dental College, Taichung, Taiwan, R.O.C. cshy029@csh.org.tw
Yang
M W
MW
Lin
C Y
CY
D000776:Anesthesiology / Q000193:education*; D001999:Bronchoscopy; D006801:Humans; D007396:Internship and Residency; D007442:Intubation, Intratracheal / Q000379:methods*; D007828:Laryngoscopy