Effect of Airway Video Library on Intubation in Novices

Endotracheal intubation requires significant training and expertise. This experience can be quite stressful for novice users. To accelerate the learning curve of newly enrolled trainees to assess and secure airway, the investigators propose supplementing current training techniques with access to an airway video library consisting of real- life clinical videos of airway and endotracheal intubations.

Study Overview

• Status: Recruiting
• Conditions: Anesthesia; Anesthesia Intubation Complication
• Intervention / Treatment: Behavioral: Airway Video Library Training; Behavioral: Conventional Airway Training

Detailed Description

Timely and correctly performed endotracheal intubation is important. It can be stressful especially among beginners and requires significant expertise. Studies suggest that endotracheal intubation success rates are below 50% for the first 10 intubations among novices and the learning curve of laryngoscopy does not plateau above a 90% success rate until a mean of 57 attempts. Although simulation, which is currently the mainstay of training for airway management help orient a novice user, it is siloed from the actual experience. Endotracheal intubation requires significant training and expertise. This experience can be quite stressful for novice users. To accelerate the learning curve of newly enrolled trainees to assess and secure airway, the investigators propose supplementing current training techniques with access to an airway video library consisting of real- life clinical videos of airway and endotracheal intubations.

• Study Type: Observational
• Enrollment (Estimated): 11

Contacts and Locations

• Study Contact: Name: Tjorvi Perry, MD, MMSc; Phone Number: (612)-602-7900; Email: perry655@umn.edu
• Study Contact Backup: Name: Litty John, MD; Phone Number: (669)-237-6473; Email: joh17977@umn.edu

Study Locations

• United States
  • Minnesota
    • Minneapolis, Minnesota, United States, 55455
      • Recruiting
      • University of Minnesota
      • Contact: John Litty; Email: littyjon@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

All the anesthesia residents employed by the University of Minnesota (UMMC) and part of the Fairview system comprise the study population. The clinic/hospitals these residents (CA-1 year) are affiliated with include University of Minnesota Medical Center East and West Bank and VA Minneapolis.

Description

Inclusion Criteria:

• Incoming anesthesia resident (CA-1 year)

Exclusion Criteria:

• Participants with prior experience of more than 60 intubations

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Group A; At the beginning of Phase 1, participants from Group A will be exposed to the video airway library in addition to the conventional airway training. At the beginning of Phase 2, participants will continue with conventional airway training only. Each phase will last for 1 month.	Behavioral: Airway Video Library Training; A video airway library consisting of real-life clinical videos of laryngoscopy and endotracheal intubation was developed by the study investigators. This library consists of video clips of normal and easy airways, pediatric airways as well as pathological or difficult airways that is devoid of patient identifying data. The participants of the study group will be exposed to the video library by two learning sessions. Each learning session consists of 1 hour of interactive & immersive learning of 30 airway videos. At the end of the session, the participants will be oriented to the airway and identify key airway structures, learn to troubleshoot and navigate difficult anatomy, optimize visualization, and use accessory airway equipment.; Behavioral: Conventional Airway Training; The endotracheal intubation training Anesthesiology students currently receive routinely as part of their education.
Group B; At the beginning of Phase 1, participants from Group B will be exposed to the conventional airway training only. At the beginning of Phase 2, the participants in Group B will be exposed to the video airway library. Each phase will last for 1 month.	Behavioral: Airway Video Library Training; A video airway library consisting of real-life clinical videos of laryngoscopy and endotracheal intubation was developed by the study investigators. This library consists of video clips of normal and easy airways, pediatric airways as well as pathological or difficult airways that is devoid of patient identifying data. The participants of the study group will be exposed to the video library by two learning sessions. Each learning session consists of 1 hour of interactive & immersive learning of 30 airway videos. At the end of the session, the participants will be oriented to the airway and identify key airway structures, learn to troubleshoot and navigate difficult anatomy, optimize visualization, and use accessory airway equipment.; Behavioral: Conventional Airway Training; The endotracheal intubation training Anesthesiology students currently receive routinely as part of their education.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Attempts to Successful Intubation	Intubation success rate will be reported in number of attempts, where lower values equate to greater success. Supervising staff report success rates.	2 months
Time for Successful Intubation	Time to successful intubation will be measured in seconds as reported by supervising staff.	2 months
Difficulty Level of Intubation as Assessed by Intubation Difficulty Scale	The supervising staff fills out a questionnaire that assesses the technical skill of laryngoscopy and the complexity of intubation as per the Intubation Difficulty Scale (IDS). Those with and without exposure to the video library will be compared. The IDS is a sum of 7 parameters. The sum value of 0 indicates easy intubation, 1-5 indicates slight difficulty, and values greater than 5 indicate moderate to high difficulty.	2 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Stress Level as Assessed by Ottawa Mood Scales	The participant fills in the Stress Scale item of the Ottawa Mood Scales with Likert scale response to reflect the stress they experienced surrounding endotracheal intubation. The scale ranges from 0 to 10, where higher scores indicate greater stress. Those with and without exposure to the video library will be compared.	2 months

Collaborators and Investigators

• Sponsor: University of Minnesota
• Investigators: Principal Investigator: Tjorvi Perry, MD, MMSc, Univeristy of Minnesota Medical School Department of Anesthesiology

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2022
• Primary Completion (Estimated): August 1, 2024
• Study Completion (Estimated): August 1, 2024

Study Registration Dates

• First Submitted: June 30, 2021
• First Submitted That Met QC Criteria: June 30, 2021
• First Posted (Actual): July 9, 2021

Study Record Updates

• Last Update Posted (Actual): March 12, 2024
• Last Update Submitted That Met QC Criteria: March 8, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: Intubation
• Other Study ID Numbers: STUDY00012340

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No