A randomised trial comparing a 4-stage to 2-stage teaching technique for laryngeal mask insertion

ObjectiveTo compare the ‘4-stage’ teaching technique (demonstration, deconstruction, formulation, performance) with the traditional ‘2-stage’ teaching technique (deconstruction, performance) in laryngeal mask airway (LMA) insertion.MethodsUsing a prospective randomised study design, participants were taught LMA insertion on a manikin by either the ‘2-stage’ or ‘4-stage’ teaching method. Subjects were eligible if they had never inserted a LMA. Skill acquisition was assessed immediately following training, and skill retention assessed a number of weeks later. The primary outcome was LMA insertion on a manikin, with successful ventilation within 30 s. Other outcomes included overall time to LMA insertion, and number of errors. Assessors were blinded to the teaching method used for each subject.ResultsA total of 120 participants were randomised between the two teaching groups (60 subjects in each group). Mean time to LMA insertion at acquisition was 39.7 s for 2-stage and 34.7 s for 4-stage (p > 0.05), and proportion completing within 30 s was 41.67% for 2-stage and 48.33% for the 4-stage teaching group (p > 0.05). With skill retention assessment, mean time to LMA insertion was 44.3 s for 2-stage and 42.5 s for the 4-stage teaching group (p > 0.05). Proportion completing task within 30 s was 34.0% for 2-stage and 41.67% for 4-stage group (p > 0.05). Overall, there was no significant difference found in skill acquisition or in skill retention between the 2 or 4-stage teaching method.ConclusionThe 2-stage teaching technique is not statistically different to the 4-stage teaching method in efficacy of LMA insertion skill acquisition or retention.