Development and Use of an Induction of General Endotracheal Anesthesia Checklist Assessment for Medical Students in a Clinical Setting During Their Introductory Anesthesiology Clerkship

Abstract

Background:The American Association of Medical Colleges deemed performing lifesaving procedures, such as airway management, a necessary medical student competency for transitioning to residency. Anesthesiology clerkships provide the unique opportunity for medical students to practice these procedures in a safe and controlled environment. We aimed to develop a checklist that assesses medical students' ability to perform the main steps of a general anesthesia induction with endotracheal intubation in the clinical setting. Methods:We created a Checklist containing items aligned with our clerkship objectives. We modified it after receiving feedback and trialing it in the clinical setting. Medical students were evaluated with the Checklist using a pre-and postclerkship study design: (1) in a simulation setting at the beginning of the clerkship; and (2) in the operating room at the end of the clerkship. Using paired t-tests, we calculated pre-and post-clerkship Checklist scores to determine curriculum efficacy. A P value of <.05 was determined to be statistically significant. We examined rater agreement between overall scores with intraclass correlation coefficients (ICC).Results: Thirty medical students participated in the study. The ICC for agreement was 0.875 (95% confidence interval [CI], 0.704-0.944). The ICC for consistency was 0.897 (95% CI, 0.795-0.950). There was a statistically significant improvement in the score from baseline to final evaluation of 3.6 points (95% CI, 2.5-5.2; P = .001). Conclusions:The statistically significant change in Checklist scores suggests that our medical students gained knowledge and experience during the introductory clerkship inducing general anesthesia and were able to demonstrate their knowledge in a clinical environment.