Videotape feedback in teaching laryngoscopy

Purpose: To evaluate if videotape feedback provides educational insights for students learning laryngoscopy that they would not otherwise perceive. Methods: Twenty-six medical students were videotaped while performing laryngoscopy for oral intubation. Before and after reviewing their performance on the videotape, they answered a standardized questionnaire assessing the adequacy of positioning, head movement during laryngoscopy, degrees of neck flexion and head extension, time elapsed, and whether the laryngoscope contacted the upper lip or teeth. After the review, they were asked if being videotaped was distracting, whether it provided new instructional insights and, if so, which was most important. Results: Only 4% of students felt that initial head and neck positioning was suboptimal and this increased to 38% after videotape review (P = 0.029). The perceived inadequacy of positioning seemed related to initial overestimation of head extension (34.0 +/- 15 degrees) compared with that seen on videotape (21.5 +/- 13.5 degrees, P = 0.003). The estimated duration of laryngoscopy was underestimated (55 +/- 32 sec vs. 75 +/- 29 sec, P=.024) before videotape review. Although 26.9% (7/26) of students admitted feeling distracted by the video camera, all felt the experience had educational value. Conclusion: Videotape feedback changed students' perception of how they performed laryngoscopy. In particular, head extension was overestimated and duration of laryngoscopy underestimated.