Improved skill for tracheal intubation using optical stylets through remote training model: a before and after interventional study

Abstract

Background: Conducting on-site, hands-on training during the Coronavirus disease 2019 (COVID-19) pandemic has been challenging. We conducted a before and after interventional study to estimate the efficacy of a new remote hands-on training model for improving the trainees’ tracheal intubation competency using optical stylets. Methods: Residents or physicians in anesthesiology apartment who have not received the nominated training in tracheal intubation using optical stylets were enrolled. The 4-week training course contains theoretical knowledge along with preclinical and clinical training of optical stylets techniques. Competency of intubation using optical stylets on patients with normal airways was evaluated according to an assessment tool with a maximum score of 29 points based on video recording pre-post training performance. Pre-post questionnaires measured theoretical knowledge and self-efficacy. Results: Twenty-two participants were included (8 females, 14 men, mean age of 33.5 years). The total score of intubation competency was significantly improved after training from 14.6±3.7 to 25.3±2.6 (P < 0.0001). The scores of three subitems (anatomical identification, hand-eye coordination, and optimized intubation condition) were all significantly increased after training (P < 0.0001). The total percentage of correct answers in the multiple-choice questionnaire increased from 58.2%±8.2% before training to 85.2%±7.2% shortly after training (P < 0.0001). In addition, the self-efficacy score was significantly increased from 2.5±1.2 to 4.4±0.6 (P < 0.0001). Conclusions: The new remote and progressively advanced hands-on training model improved the competency of intubation using optical stylets under the COVID-19 pandemic.