Human patient simulation is effective for teaching paramedic students endotracheal intubation.
OBJECTIVE
The primary purpose of this study was to determine whether the endotracheal intubation (ETI) success rate is different among paramedic students trained on a human patient simulator versus on human subjects in the operating room (OR).


METHODS
Paramedic students (n = 36) with no prior ETI training received identical didactic and mannequin teaching. After randomization, students were trained for ten hours on a patient simulator (SIM) or with 15 intubations on human subjects in the OR. All students then underwent a formalized test of 15 intubations in the OR. The primary outcome was the rate of successful intubation. Secondary outcomes were the success rate at first attempt and the complication rate. The study was powered to detect a 10% difference for the overall success rate (alpha = 0.05, beta = 0.20).


RESULTS
The overall intubation success rate was 87.8% in the SIM group and 84.8% in the OR group (difference of 3.0% [95% confidence interval {CI} = -4.2% to 10.1%; p = 0.42]). The success rate on the first attempt was 84.4% in the SIM group and 80.0% in the OR group (difference of 4.4% [95% CI = -3.4% to 12.3%; p = 0.27]). The complication rate was 6.3% in the SIM group and 4.4% in the OR group (difference of 1.9% [95% CI = -2.9% to 6.6%; p = 0.44]).


CONCLUSIONS
When tested in the OR, paramedic students who were trained in ETI on a simulator are as effective as students who trained on human subjects. The results support using simulators to teach ETI.
Hall
Robert E
RE
Department of Emergency Medicine, University of Calgary, Calgary, Alberta, Canada. rehall@shaw.ca
Plant
Jeff R
JR
Bands
Colin J
CJ
Wall
Alastair R
AR
Kang
Jian
J
Hall
Christine A
CA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000488:Allied Health Personnel / Q000193:education*; D002648:Child; D002675:Child, Preschool; D004521:Educational Measurement; D006801:Humans; D007442:Intubation, Intratracheal; D008348:Manikins; D008875:Middle Aged; D016544:Patient Simulation; D011446:Prospective Studies; D013663:Teaching / Q000379:methods