Analysis of Medical Students’ Success Performing Endotracheal Intubation (ETI) and Predictive Model for Success Probability

Introduction: Endotracheal intubation (ETI) is a critical skill every medical student should master during their education, at least on the basic level. Today, approaches in training and evaluating medical students regarding ETI vary, each with its benefits and drawbacks. The aim of this analysis was to comparatively evaluate different components of medical students’ education regarding ETI. Materials and methods: From the PubMed database, we selected 16 studies that reported on medical student ETI success rates with various training and evaluation techniques. The variables observed were time period of study, evaluation setting, evaluation technique, and training type, while the primary outcome was average intubation success rate (ASR). Results: The analysis included 1610 medical students. A statistically significant superior score was noted in the indirect laryngoscopy subgroup compared to direct laryngoscopy, the mannequin model subgroup compared to operating room patients, and the standard training subgroup compared to advanced simulator training. Additionally, the trend of ASR change from the 1980s to today was shown to be significantly positive. Finally, as a form of result validation, we used machine learning modelling for intubation success prediction. Based on the provided variables, the model had a > 90% accuracy in predicting which student might have a higher than 70% probability of success. Conclusions: In conclusion, this study demonstrates a significant improvement in student intubation skills over time, as well as a clear superiority of indirect laryngoscopy scores, and provides a contribution to the determination of an optimal educational program for ETI skill acquisition.