# Evaluating the Effectiveness of Video Laryngoscopy Versus Direct Laryngoscopy as a Training Tool for Pediatric Intubation Skills in Simulation Settings

## TL;DR

This study compares video laryngoscopy and direct laryngoscopy as training tools for medical students learning pediatric intubation, finding that video laryngoscopy reduces intubation time.

## Contribution

The study provides new evidence on the effectiveness of video laryngoscopy for training medical students in pediatric intubation.

## Key findings

- Video laryngoscopy significantly reduced intubation time compared to direct laryngoscopy.
- There were no significant carry-over effects between the two methods in terms of attempts or success rates.

## Abstract

Introduction: Training U.S. accredited medical school students in pediatric endotracheal intubation is currently underdeveloped, with significant room for improvement. While research has consistently demonstrated the advantages of video laryngoscopes (VL) over direct laryngoscopes (DL) in adults, there is limited data on the effectiveness of VL in training for pediatric simulation. Neonatal intubation presents a high rate of adverse events. Additionally, success rates for neonatal intubation are notably low among junior residents. The integration of simulated intubation training during U.S. medical students' first two years of training remains limited and poorly researched.

Study question: This study evaluated and compared the effectiveness of VL versus DL as training tools for medical students performing intubation on pediatric patients. Which method better enhances intubation success rates and improves technical skills during the training process?

Methods: Ninety-three medical students in their second year of training out of four with no or minimal prior experience in intubation were randomized into two groups, Group A and Group B. The groups differed in the sequence of intubation equipment use. All participants were exposed to a tutorial video before intubating. Number of attempts and time to successful intubation were recorded.

Results: Tests of carry-over effects were not significant for time to intubation, number of attempts, and proportion failing. We observed that VL produced a statistically significant lower intubation time among all participants.

Conclusion: Insufficient training in pediatric intubation, such as identifying anatomical landmarks and mastering correct techniques, may contribute to the high rate of adverse effects in real-life intubation rates. This study shows the importance of providing medical students with accurate, hands-on training in pediatric intubation. The VL has the potential to enhance the students’ understanding of key anatomical landmarks and proper intubation techniques. Further research is needed to fully support or reject the hypothesis that teaching with VL will improve intubation success rates.