Self-Confidence in Endotracheal Intubation Among Pediatric Interns: Associations With Gender, Experience, and Performance.


Journal

Academic pediatrics
ISSN: 1876-2867
Titre abrégé: Acad Pediatr
Pays: United States
ID NLM: 101499145

Informations de publication

Date de publication:
Historique:
received: 29 11 2018
revised: 12 06 2019
accepted: 17 06 2019
pubmed: 24 6 2019
medline: 5 9 2020
entrez: 24 6 2019
Statut: ppublish

Résumé

Supervisors' decisions regarding procedural readiness are influenced by resident confidence. Confidence is a valuable metric if we understand how it correlates with trainee characteristics and procedural competence. Our objective was to evaluate the relationship between self-reported confidence in endotracheal intubation (ETI) and pediatric interns' characteristics (gender, prior intubation experience) and performance (airway management knowledge, demonstrated skills on airway trainers). This was a secondary analysis of a randomized, controlled trial of an airway management curriculum. Gender and prior intubation experience were reported on a preparticipation questionnaire. Interns' performance was measured 1) using a 14-item knowledge-based assessment of airway management and 2) as time to successful intubation across 4 simulated intubation scenarios. After completing the curriculum and assessment, interns reported retrospective precurriculum and current postcurriculum confidence with ETI using a 10-point Likert scale. Forty-nine interns participated, of whom 16 (33%) were male. Eleven (22%) had ≥1 previous successful intubation. Median [interquartile range] pre- and postcurriculum confidence scores were 3 [2, 5] and 6 [5, 8], respectively. Male interns reported higher precurriculum confidence than females (median difference: 2.0; 95% confidence interval: 0.1, 3.9); postcurriculum confidence among males was also higher but not statistically significant. There was no correlation between self-reported precurriculum confidence and prior experience. There was no correlation between pre- or postcurriculum self-reported confidence and performance on the knowledge-based assessment or time to successful intubation on airway trainers. Male pediatric interns self-report higher initial confidence in ETI compared to females. Self-reported confidence did not correlate with prior experience, airway management knowledge, or intubation performance on airway trainers.

Sections du résumé

BACKGROUND AND OBJECTIVE
Supervisors' decisions regarding procedural readiness are influenced by resident confidence. Confidence is a valuable metric if we understand how it correlates with trainee characteristics and procedural competence. Our objective was to evaluate the relationship between self-reported confidence in endotracheal intubation (ETI) and pediatric interns' characteristics (gender, prior intubation experience) and performance (airway management knowledge, demonstrated skills on airway trainers).
METHODS
This was a secondary analysis of a randomized, controlled trial of an airway management curriculum. Gender and prior intubation experience were reported on a preparticipation questionnaire. Interns' performance was measured 1) using a 14-item knowledge-based assessment of airway management and 2) as time to successful intubation across 4 simulated intubation scenarios. After completing the curriculum and assessment, interns reported retrospective precurriculum and current postcurriculum confidence with ETI using a 10-point Likert scale.
RESULTS
Forty-nine interns participated, of whom 16 (33%) were male. Eleven (22%) had ≥1 previous successful intubation. Median [interquartile range] pre- and postcurriculum confidence scores were 3 [2, 5] and 6 [5, 8], respectively. Male interns reported higher precurriculum confidence than females (median difference: 2.0; 95% confidence interval: 0.1, 3.9); postcurriculum confidence among males was also higher but not statistically significant. There was no correlation between self-reported precurriculum confidence and prior experience. There was no correlation between pre- or postcurriculum self-reported confidence and performance on the knowledge-based assessment or time to successful intubation on airway trainers.
CONCLUSIONS
Male pediatric interns self-report higher initial confidence in ETI compared to females. Self-reported confidence did not correlate with prior experience, airway management knowledge, or intubation performance on airway trainers.

Identifiants

pubmed: 31229695
pii: S1876-2859(19)30301-8
doi: 10.1016/j.acap.2019.06.013
pii:
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

822-827

Informations de copyright

Copyright © 2019 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Auteurs

Kelsey A Miller (KA)

Division of Emergency Medicine, Department of Medicine (KA Miller, MC Monuteaux, and J Nagler), Boston Children's Hospital, Boston, Mass. Electronic address: kelsey.miller@childrens.harvard.edu.

Michael C Monuteaux (MC)

Division of Emergency Medicine, Department of Medicine (KA Miller, MC Monuteaux, and J Nagler), Boston Children's Hospital, Boston, Mass.

Christopher Roussin (C)

Boston Children's Hospital Simulator Program, Center for Life Sciences Building (C Roussin), Boston, Mass.

Joshua Nagler (J)

Division of Emergency Medicine, Department of Medicine (KA Miller, MC Monuteaux, and J Nagler), Boston Children's Hospital, Boston, Mass.

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