Enhancing Cricothyroidotomy Training for Novices Using Three-Dimensional-Printed Patient-Specific Models of a Patient with Obesity.

Abstract

This study aimed to enhance cricothyroidotomy training for novice practitioners using three-dimensional-printed patient-specific models based on computed tomography images of a patient with obesity, evaluate these models compared to conventional training phantoms, and suggest possible effective training methods. A prospective, randomised crossover study was conducted with 30 medical students with no prior cricothyroidotomy experience. Participants performed the procedure on a conventional and a patient-specific model. Performance was assessed using time, visual inspections, and a three-dimensional scanner to evaluate the accuracy of the cricothyroidotomy simulation. The correlation between total time and checklist times for procedural step skills was analysed. Furthermore, a post-study survey was conducted to evaluate participants' perceptions of the realism and utility of both simulators. Patient-specific simulators required a longer time (18.63 ± 6.96 s) to confirm tracheal position compared to conventional simulators (15.28 ± 6.96 s; p = 0.034). Conversely, conventional simulators required a longer time (44.86 ± 27.56 s) to intubate than patient-specific simulators (27.96 ± 9.73 s; p < 0.001). Patient-specific simulators exhibited a greater deviation from the intended puncture site (17.14 ± 8.03 mm) compared to conventional simulators (2.95 ± 1.25 mm; p < 0.001), despite high visual success rates for both models. Survey results showed significantly higher ratings for the patient-specific simulator in terms of fidelity, utility, and special features (p < 0.001). This study assessed both time and accuracy in evaluating and enhancing training and procedural outcomes, being the first to incorporate a three-dimensional scanner into assessing outcomes. The findings, along with positive participant feedback from the post-study survey, emphasise the need for specialised training programmes incorporating a three-dimensional-printed, patient-specific models that reflect challenging scenarios particularly involving patients with obesity.