Identifying the Gap Between Novices and Experts in Fiberoptic Scope Control.

Abstract

Background: Fiberoptic intubation (FOI) is key in managing difficult airways. Good scope control increases efficiency and patient safety. Understanding the gap between novices and experts in scope control would help medical educators develop a feedback-based teaching approach for novices. We designed and used a checklist for evaluating the gap in fiberoptic scope control between novices and experts.

Methods: Twelve first-year anesthesiology residents (novice group) attended a lecture, followed by hands-on practice with a fiberoptic scope on a manikin. Five staff anesthesiologists (expert group) only did the hands-on practice. After practice, each participant was video-recorded while conducting an FOI on the manikin. Two senior anesthesiologists developed and used a 7-item checklist to assess the FOIs. Checklist scores and total times for FOIs were compared between groups using the Mann-Whitney U test. Internal consistency of the checklist items, interrater reliability, and the relationship between checklist score and total time for FOI were assessed with Cronbach alpha, Cohen kappa, and the Pearson correlation coefficient, respectively.

Results: Experts had higher checklist scores than novices (P = .0016). The item with the lowest success rate for novices (50%) was keeping the scope straight. Novices spent more time on the FOI than experts (P = .0005). Cronbach alpha, Cohen kappa, and the Pearson correlation coefficient were 0.8699, 0.75, and -0.9454, respectively.

Conclusions: Our checklist was used to detect differences in fiberoptic scope control skills between novices and experts. With a video-based assessment method, it can be used to develop a feedback-based teaching method for fiberoptic scope control.