Effectiveness of Simulation-Based Training in Improving Endotracheal Intubation Competence Among Undergraduate Medical Students: A Prospective Interventional Study

Abstract

Background: Endotracheal intubation is a critical, life-saving procedure requiring not only theoretical knowledge but also well-developed procedural skills and clinical judgment. Traditional teaching meth-ods for undergraduate medical students are increasingly limited by medico-legal concerns and patient safety priorities. Simulation-based training (SBT) has emerged as a valuable educational tool, offering safe, controlled environments for procedural practice. This study aimed to assess the effectiveness of simulation-based training in improving endotracheal intubation competence among undergraduate med-ical students.
Methods: A prospective interventional study was conducted at the Department of Anaesthesiology, Dr. Sushila Tiwari Memorial Government Hospital, Haldwani, India, over 18 months. A total of 140 medi-cal interns were randomly assigned to either a Simulation group (n=70) or a Non-simulation group (n=70). Both groups received standardized theoretical training, followed by six days of either manne-quin-based simulation practice or hands-on clinical practice. On the seventh day, endotracheal intuba-tion competence was assessed in the operating theatre by a blinded assessor using a validated 6-item scoring system. Secondary outcomes included intubation time, trainee satisfaction, and complication rates.
Results: Both groups were demographically comparable in terms of age (p=0.77) and gender distribu-tion (p=0.61). The Simulation group demonstrated significantly faster mean intubation times (8.27 ± 3.64 seconds vs. 9.79 ± 3.84 seconds; p=0.018), higher equipment handling scores (p=0.001), and bet-ter intubation technique scores (p=0.019) compared to the Non-simulation group. Overall competency scores were also significantly higher in the Simulation group, with 75.7% achieving excellent scores versus 41.4% in the Non-simulation group (p<0.001). Individual satisfaction was markedly higher in the Simulation group (94.3% vs. 61.4%; p<0.001). Although complication rates were lower in the Simu-lation group, the difference was not statistically significant (p=0.30).
Conclusion: Simulation-based training significantly enhances endotracheal intubation competence, pro-cedural efficiency, technical proficiency, and learner satisfaction among undergraduate medical stu-dents. These benefits were independent of demographic factors and support the integration of simula-tion modules into undergraduate medical curricula to improve procedural skills and patient care out-comes.