Video-recorded Endotracheal Intubations: An Educational Tool in Airway Management Training for Pulmonary and Critical Care Fellows.

Abstract

Expert airway management is an essential skill for pulmonary and critical care fellows. Providing high-quality real-time feedback to trainees performing emergent intubations is often limited because of the acuity of the situation and the lack of full airway visualization by the supervising provider. We sought to improve the quality of airway management education in a pulmonary and critical care fellowship training program by recording all emergent intubations and systematically reviewing select videos at a regularly scheduled airway management conference. We introduced several modifications to our airway training curriculum, including the recording of all fellow-performed emergent tracheal intubations along with a regularly scheduled conference in which selected videos recordings were systematically reviewed. Surveys completed by trainees before and after the redesign of the curriculum were used to determine the efficacy of the individual curriculum modifications. Paired Student's t tests, χ2 tests, and Kruskal-Wallis tests were used for statistical analysis. A P value lower than 0.05 was considered significant in all analyses. After completion of the redesigned curriculum, trainees (100% response rate) demonstrated improved technical knowledge (P < 0.04) and procedural confidence (P < 0.04) with regard to airway management. Of the modifications incorporated into the curriculum redesign, fellows ranked the video-recorded intubation review conference as the most beneficial (P = 0.001) of the educational interventions. Recording of trainee-performed intubations and subsequent review of these videos using a standardized rubric was a highly valued modification to our fellowship airway training curriculum.