[Orotracheal intubation training: assessment with the cumulative sum method]

Abstract

Objectives: Orotracheal intubation is one of the first techniques a new resident learns. The cumulative sum (cusum) method has been shown to be a useful tool for the assessment of learning, as it provides qualitative and quantitative information that allows technical competence to be certified. The aim of this study was to use the cusum method to assess the learning of orotracheal intubation by a group of first year residents.

Methods: The residents were evaluated at 2 stages. In the first, the acceptable failure rate was set at 10% and in the second it was reduced to 5%. Learning curves were constructed for each resident for both stages.

Results: Eight residents were evaluated. They performed 868 intubations, 330 at the first stage and 538 at the second. Forty (4.6%) of the intubations failed: 26 (7.9%) in the first stage and 14 (2.6%) in the second. All residents achieved the acceptable failure rate of 10% in the first 3 months with a mean (SD) number of intubations of 41.3 (6). All achieved the 5% acceptable failure rate within the 11 months of study, after a mean of 67.3 (28) intubations.

Conclusions: The cusum method proved a useful tool for training residents to perform tracheal intubation. It afforded objective information on performance and facilitated evaluation while learning was taking place.