# Comparing conventional versus 3D printed simulators for simulation training of emergency percutaneous cricothyrotomy with two different kits: a randomized controlled trial

## TL;DR

This study compares conventional and 3D-printed simulators for training emergency percutaneous cricothyrotomy, finding both equally effective in improving performance and safety perceptions.

## Contribution

The study introduces a novel comparison of conventional and 3D-printed simulators for PC training using a crossover design and two different kits.

## Key findings

- Both simulators improved procedural performance and safety perceptions equally.
- Quicktrach II showed faster procedural times, while Surgicric III required more practice due to complexity.
- Participants rated both simulators similarly in educational benefit and realism.

## Abstract

Effective procedural training is crucial for emergency interventions such as percutaneous cricothyrotomy (PC). This study evaluated simulation-based training of PC by comparing two simulators, a commercially available conventional simulator (CSIM) and an innovative 3D-printed simulator (3DSIM), and assessed their impact on procedural performance and subjective safety perceptions using two different PC kits: Quicktrach II (direct puncture method) and Surgicric III (Seldinger technique).

Forty-four participants underwent standardized theoretical training and were randomized into two groups: Group A initially trained with CSIM and Group B with 3DSIM. In both groups, procedural performance was evaluated immediately after each simulation session on porcine trachea models by two blinded assessors. Outcomes included procedural time, standardized performance scores, and subjective safety ratings. Participant evaluations of educational benefit and simulator realism were also recorded. Training effectiveness was reassessed in a second session using a crossover design, allowing direct comparison of the two simulators and kits.

Procedural performance improved significantly after repeated training, with no significant differences between CSIM and 3DSIM regarding procedural times (p = 0.98) or accuracy scores (p = 0.99). Both PC kits showed significantly reduced procedural times (Quicktrach II: 42 ± 46 to 19 ± 7 s, p < 0.01; Surgicric III: 119 ± 73 to 91 ± 51 s, p = 0.03). Accuracy improved significantly only for Surgicric III (95 ± 10% to 98 ± 4%, p = 0.04). Participants’ perceived safety improved similarly for both simulators (44 ± 20% to 94 ± 9%), without differences in educational benefit or realism ratings.

Conventional and 3D-printed simulators were equally effective in enhancing procedural performance and subjective safety perceptions in PC training. Procedural time improvements differed by kit complexity, suggesting Quicktrach II offers quicker initial mastery, whereas Surgicric III may require additional practice due to its greater complexity. These results support flexible simulator choice based on local factors like cost and availability, underscoring the potential of 3D-printed simulators for procedural training programs.

Not applicable.

The online version contains supplementary material available at 10.1186/s41205-026-00315-z.