First-attempt success significantly higher in intervention group receiving expert intubation coaching on a manikin<\/p>\n<\/h3>\n
By Elana Gotkine HealthDay Reporter<\/b>
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TUESDAY, Dec. 17, 2024 (HealthDay News) — For inexperienced clinicians, just-in-time training leads to increased first-attempt success of infant intubation, according to a study published online Dec. 16 in The BMJ<\/em>.<\/p>\n Stephen G. Flynn, M.D., from Harvard Medical School in Boston, and colleagues examined whether training provided to inexperienced clinicians just before performing a high-stakes procedure can improve procedural care quality in a noncrossover, parallel-group trial. Volunteer trainees, including pediatric anesthesia fellows, residents, and student-registered nurse anesthetists from 10 regional training programs, were block-randomized by training roles; trainees were intubating infants aged 12 months and younger with an American Society of Anesthesiology physical status classification of I to III. The trainee treatment group received preoperative just-in-time expert intubation coaching on a manikin within one hour of infant intubation, and the control group received unstructured intraoperative instruction.<\/p>\n Overall, 172 participants were randomly assigned and 153 were analyzed. The 153 trainees (83 control and 70 treatment) performed 515 intubations (283 control and 232 treatment). The researchers found that first-attempt success was 91.4 and 81.6 percent in the trainee treatment and control groups, respectively, in the modified intention-to-treat analysis (odds ratio, 2.42). Secondary outcomes favored the intervention, with significantly lower cognitive load and improved competency. Complications were lower for the intervention group, but not significantly so.<\/p>\n “Integrating a just-in-time approach into airway management training could improve patient safety and serve as a proof of concept for improving high-stakes procedural outcomes more broadly,” the authors write. “Randomized evaluation in other settings is warranted.”<\/p>\n Two authors disclosed ties to the pharmaceutical industry; one also disclosed ties to the publishing industry.<\/p>\n