Stylet Shape in Simulated Endotracheal Intubation by Medical Students

National University Health System (NUHS)

Status: Enrolling

Conditions: Endotracheal Intubation; Medical Education

Treatments: Procedure: Endotracheal intubation using an endotracheal tube with a 30 degree straight to cuff shape; Procedure: Endotracheal intubation using an endotracheal tube with an arcuate cuff shape

Study type: Interventional

Funder types: Other

Identifiers

NCT06525662

NUS-L2023-08-01

Details and patient eligibility

About

Endotracheal intubation is a life saving procedure where a tube is placed into a person's windpipe to help them to breathe. This is a study of which shape of tube would lead to improved success in this procedure.

Full description

Endotracheal intubation (ETI) is a lifesaving procedure. It involves placing a tube in the patient's airway to maintain ventilation and oxygenation.

Simulation has been shown to be effective for medical procedural skills training. Medical simulation literature now focuses on instructional design (ID) features that improve learning.

There are multiple aspects of ETI technique and ID that can be modified to improve successful ETI. Patient positioning, mastery learning, and dyad rather than solo practice are examples for which evidence exists to guide instructors. Despite this, ETI complication rates are substantial.

Thus, areas for continued improvement in ETI ID should be explored. One area is the optimal endotracheal tube (ETT) shape, achieved using a stylet, for novices learning ETI, for which there is limited evidence.

The straight to cuff (STC) shape has been postulated to optimise views of the airway compared to an arcuate shape. These shapes have only been directly compared as subgroups among multiple other comparisons in ETI technique in difficult intubations in one study. This does not generalise well to educating novices such as medical students, where intubations at normal difficulty are within the learner's zone of proximal development, and findings from subgroup comparisons are hypothesis generating rather than definitive evidence

This study will compare which shape is most likely to lead to successful endotracheal intubation, when performed by novices (medical students) learning this procedure on mannequins.

Enrollment: 268 estimated patients

Sex: All

Ages: 21+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Final year medical students in the Yong Loo Lin School of Medicine, National University of Singapore, undergoing their simulation posting. Endotracheal intubation is a procedure that is taught during this posting.

Exclusion criteria

• Injuries precluding performance of endotracheal intubation. Non exhaustive examples include arm injuries.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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268 participants in 2 patient groups

30-degree straight to cuff

Experimental group

Description:

The endotracheal tube to be used for endotracheal intubation will have a stylet inserted into it and manipulated into a shape that is straight from its proximal end to the cuff. At the cuff, there will be a 30 degree anterior bend.

Treatment:

Procedure: Endotracheal intubation using an endotracheal tube with a 30 degree straight to cuff shape

Arcuate

Active Comparator group

Description:

The endotracheal tube to be used for endotracheal intubation will have a stylet inserted into it and manipulated into an arcuate shape, and thus curved throughout the length of the tube.

Treatment:

Procedure: Endotracheal intubation using an endotracheal tube with an arcuate cuff shape