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Simulation-based training on airway management: the experience with 311 trainees


Because ventilation and endotracheal intubation can be life saving for a patient in respiratory distress, airway management is among the key requirements of appropriate therapy in emergency and critically ill patients. Medical simulation used in combination with traditional training methods can provide a comprehensive learning opportunity that allows the clinician to safely learn, practice, and repeat the procedure until proficiency is achieved.


To address the use of medical simulation as a way for medical learners to acquire and maintain the skills needed to manage difficult airways. To evaluate the students' satisfaction with the course.


The study was performed at Berkeley Training Center – Brazil, between August 2005 and February 2007, with a total number of 311 trainees. Trainees received a baseline evaluation followed by an 8-hour training session that involved an introductory lecture, a computer-enhanced mannequin simulator, clinical scenarios for training procedural skills in a difficult airway algorithm, and instructor-facilitated debriefings. After finishing the course, the trainees were retested and completed a numerical scale survey of their perceptions about our course (1 = poor, 2 = fair, 3 = good, and 4 = excellent).


Performance improved significantly after simulator training (48.5% vs 72.7%, P < 0.001). Seventy-five percent of participants scored less than 60% in the baseline evaluation, while only 25% scored less than 65% in the retest. The course was considered excellent by 70% of the participants and good by 29%.


The extremely positive response to simulation-based training on airway management found in this pilot study suggests that this training modality may be valuable in the training of medical students and physicians. Simulation-based training is expected to become routine in many healthcare settings in the coming decade.


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Zawadzki, B., Gelbvaks, S., Paoli, D. et al. Simulation-based training on airway management: the experience with 311 trainees. Crit Care 11, P112 (2007).

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  • Airway Management
  • Baseline Evaluation
  • Difficult Airway
  • Simulator Training
  • Procedural Skill