Abstract
BackgroundTracheal intubation (TI) is a key medical skill used by anesthesiologists and critical care physicians in airway management in operating rooms and critical care units. An objective assessment of dexterity in TI procedures would greatly enhance the quality of medical training. This study aims to investigate whether any biomechanical parameters obtained by 3D-motion analysis of body movements during TI procedures can objectively distinguish expert anesthesiologists from novice residents.MethodsThirteen expert anesthesiologists and thirteen residents attempted TI procedures on an airway mannequin using a Macintosh laryngoscope. Motion capturing technology was utilized to digitally record movements during TI procedures. The skill with which experts and novices measured biomechanical parameters of body motions were comparatively examined.ResultsThe two groups showed similar outcomes (success rates and mean time needed to complete the TI procedures) as well as similar mean absolute velocity values in all 21 body parts examined. However, the experts exhibited significantly lower mean absolute acceleration values at the head and the left hand than the residents. In addition, the mean-absolute-jerk measurement revealed that the experts commanded potentially smoother motions at the head and the left hand. The Receiver Operating Characteristic (ROC) curves analysis demonstrated that mean-absolute-acceleration and -jerk measurements provide excellent measures for discriminating between experts and novices.ConclusionsBiomechanical parameter measurements could be used as a means to objectively assess dexterity in TI procedures. Compared with novice residents, expert anesthesiologists possess a better ability to control their body movements during TI procedures, displaying smoother motions at the selected body parts.
Highlights
Tracheal intubation (TI) is a key medical skill used by anesthesiologists and critical care physicians in airway management in operating rooms and critical care units
The biomechanical parameters at many of the 21 body parts were indistinguishable between the expert and the novice groups, we observed consistent and statistically significant inter-group differences in selected parameters, those related to the head and the left hand, as discussed below
The Receiver Operating Characteristic (ROC) curves analysis demonstrated that the acceleration and jerk measurements at select body parts serve as an excellent means to distinguish between experts and novices
Summary
Tracheal intubation (TI) is a key medical skill used by anesthesiologists and critical care physicians in airway management in operating rooms and critical care units. An objective assessment of dexterity in TI procedures would greatly enhance the quality of medical training. Tracheal intubation (TI) is a core clinical skill for airway management, both in general anesthesia and in critical care medicine. Anesthesiologists usually learn to confidently perform the TI procedure during their residency training. How well trainees perform the TI procedure has often been subjectively evaluated by trainers (i.e., senior expert anesthesiologists). Implementation of objective and quantitative measures to assess trainees’ clinical procedural skills would improve the quality of medical education and resident training, the development and validation of such means remain challenging
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