Simulation and Acquisition of Endotracheal Intubation Skills by Medical Students—A Pilot Study

Abstract

Introduction: Endotracheal intubation is a vital life-saving skill required by physicians in life-threatening situations in and out of the hospital. Medical students are exposed to these procedures mainly as they rotate through the department of Anaesthesia, in their subspecialty posting in Surgery. In this study, we sought to assess the ease of learning endotracheal intubation by medical students in the skills laboratory using an adult-sized (Laerdal Medical) manikin. Methods: This was a prospective descriptive study assessing the ability of medical students at endotracheal intubation during their 12-week rotation in the Anaesthesia Department during their subspecialty posting from August to October 2019 in the Skills Laboratory. An adult-sized manikin (Laerdal Medical) intubating head was used for the study. This was preceded by a detailed lecture and demonstration in the skills laboratory after successful passage of the endotracheal tube and connected to a self-inflating ventilation (Ambou) bag. Adequate chest movement meant proper placement, while the fullness of the stomach meant oesophageal intubation. Results: All the 500 level (45) students in the class were recruited for this prospective study. 30 (66%) had successful endotracheal intubation at the first attempt, 7 (14.4%) at the second attempt, 5 (11.1%) at the third attempt, 2 (4.4%) students at the fourth attempt and 1 (2.2%) had successful endotracheal intubation at the fifth attempt. Attempts were made to reinforce information on the practical procedure by a repeat performance by the instructor after each set of successful attempts was separated from the pack of unsuccessful candidates. In the end, however, we had 100% successful endotracheal intubation, but after 5 attempts by the last medical student. Conclusion: Endotracheal intubation skills can be learned with some level of ease when done after detailed information and training of medical students. More so when not under undue stress and life-threatening situations in the skills laboratory. By extension, this increases the confidence of medical students in the live patients in the Operating Theatre, after repeated attempts in the skills laboratory. This has the benefit of improving the chances of acquisition of endotracheal intubation in real-life situations.