title: Evaluation of tracheal intubation: A retrospective study of skill acquisition by medical students in the operating theater.
abstract: OBJECTIVE
  Tracheal intubation is a critical life-saving invasive procedure. Medical students generally obtain the skill of performing tracheal intubation in the operating theater during their anesthesiology rotation. In this study, we sought to characterize medical students' skill acquisition of tracheal intubation.
  
  
  METHODS
  We retrospectively reviewed the logbooks of 94 medical students who had completed a 3-4 week rotation in our department between January 2011 and June 2012.
  
  
  RESULTS
  Ninety-four students performed 934 tracheal intubations. The success rate of intubation was 76.7%. After adjustment for age, body mass index, Mallampati class and grade, American Society of Anesthesiology (ASA) scores, and surgical category, the odds ratio of successful tracheal intubation improved with cumulative practice [odds ratio (OR) = 1.05 for each additional intubation performed; 95% confidence interval (CI) 1.00-1.09]. By contrast, the success rate decreased significantly with increasing scores of Mallampati class (OR = 0.32 for each increase in class; 95% CI 0.23-0.24) and grade (OR = 0.57 for each increase in grade; 95% CI 0.39-0.84). The main reason for intubation failure (57%) was poor visualization of vocal cords, due to suboptimal placement of the position of the laryngoscope. The satisfaction and confidence of students regarding the ability of performing tracheal intubation increased with each additional procedure, but decreased significantly after multiple unsuccessful attempts and the occurrence of any complication.
  
  
  CONCLUSIONS
  Medical students acquired the ability of tracheal intubation and overcame major challenges through cumulative clinical practice of the procedure.
authors.affiliation: Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Anne
authors.initials: A
authors.lastname: Chao
authors.affiliation: Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Wei-Han
authors.initials: WH
authors.lastname: Chou
authors.affiliation: Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Hsing-Hao
authors.initials: HH
authors.lastname: Huang
authors.affiliation: Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Yu-Chang
authors.initials: YC
authors.lastname: Yeh
authors.affiliation: Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: anesthesiolin@gmail.com.
authors.forename: Chen-Jung
authors.initials: CJ
authors.lastname: Lin
mesh_terms: D002983:Clinical Competence; D004501:Education, Medical; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D059032:Learning Curve; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D009873:Operating Rooms; D012189:Retrospective Studies; D013337:Students, Medical / Q000706:statistics & numerical data*; D013624:Taiwan
keywords: education; medical student; tracheal intubation