📄 medicine

Comparing the Effectiveness of Direct Laryngoscopy and Video Laryngoscopy (GlideScope®) Training on Medical Students' Performance: A Randomized Controlled Trial

This randomized controlled trial involving 42 medical students found that training with either GlideScope® video laryngoscopy or direct laryngoscopy resulted in comparable intubation success rates, skill acquisition speeds, and satisfaction levels, suggesting both methods are equally effective for teaching endotracheal intubation to novices.

Original authors: Mohamadali Jafari, Ali Raee Ezzabadi, Hamid Mirjalili, Faeze Zeinali.N, Mohammadreza Rafiee Dehnavi, Amin Rahimpour, Zinatalsadat Dehghan

Published 2026-06-30

📖 4 min read☕ Coffee break read

CC BY 4.0

Original authors: Mohamadali Jafari, Ali Raee Ezzabadi, Hamid Mirjalili, Faeze Zeinali.N, Mohammadreza Rafiee Dehnavi, Amin Rahimpour, Zinatalsadat Dehghan

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ✨ This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer

Imagine you are teaching a group of new drivers how to park a car. You have two different ways to teach them:

The "Old School" Method (Direct Laryngoscopy): You stand right next to the driver, looking over their shoulder. You can only see what they see through the windshield. If you want to show them a specific angle, you have to lean in close, which can be cramped and makes it hard for both of you to see the same thing clearly at the same time.
The "High-Tech" Method (GlideScope® Video Laryngoscopy): The car has a built-in dashboard camera that streams a live video feed to a screen on the roof. Now, both the teacher and the student can look at the same screen simultaneously. The teacher can point at the screen to say, "Turn the wheel here," without having to get physically close to the driver.

The Study's Mission
This research paper is like a driving school experiment. The researchers wanted to find out: Which teaching method helps medical students learn to "park" (intubate a patient's airway) better and faster?

They took 42 fifth-year medical students who had never done this before. They split them into two groups:

Group A learned using the "Old School" mirror-like tool (Direct Laryngoscope).
Group B learned using the "High-Tech" camera tool (GlideScope).

Both groups practiced on a realistic dummy (a mannequin) five times in a row. The researchers measured three things:

Did they succeed? (Did they get the tube in?)
How fast were they? (How many seconds did it take?)
Were they happy? (Did they like the tool they used?)

What They Found
Here is the breakdown of the results, translated into plain English:

Both Tools Work Great: Both groups were very successful. About 90% to 95% of the time, the students managed to do the task correctly. It wasn't a case of one tool being a "magic wand" and the other being useless; both got the job done.
The Learning Curve: As the students practiced, they got faster and better at it, no matter which tool they used. It was like driving practice: the first time was slow and clumsy, but by the fifth time, everyone was much smoother. The speed of improvement was the same for both groups.
The "Trend" (The Almost-Win): While the numbers weren't statistically different (meaning the difference could have been due to luck), the "High-Tech" group (GlideScope) had a slight edge in two areas:
- More students in the GlideScope group managed to get a "perfect score" (succeeding all 5 times).
- More students in the GlideScope group said they were "very satisfied" with their training.
- Think of it like this: If you were betting on who would get a perfect score, you might lean toward the camera group, but the odds weren't high enough to say for sure that the camera caused the win.
No Gender or Knowledge Bias: It didn't matter if the student was male or female, or if they knew a little bit about the topic before starting. Both tools worked equally well for everyone.

The Bottom Line
The study concludes that both methods are excellent for teaching beginners.

While the video camera (GlideScope) showed a slight, non-significant trend toward helping students get perfect scores and feel happier with the training, the "old school" mirror method (Direct Laryngoscopy) was just as effective at teaching the core skills.

Why This Matters (According to the Paper)
The paper suggests that because the video tool allows the teacher and student to look at the same screen at the same time, it is a great tool for teaching, especially in situations where you want to keep a safe distance (like during a pandemic). However, if a school doesn't have the money for the expensive video cameras, the traditional tool is still a very reliable way to teach students how to do this life-saving skill.

In short: You can teach someone to drive a car just as well with a side mirror as you can with a rear-view camera, though the camera might make the lesson feel a little more modern and fun for some students.

Technical Summary: Comparing Direct and Video Laryngoscopy Training for Medical Students

Problem Statement
Tracheal intubation is a critical skill in emergency and intensive care medicine, yet training medical students presents significant challenges. Traditional direct laryngoscopy (DL) training is constrained by the brevity of the procedure (20–30 seconds), the inability to extend the learning window, and the limitation that only one person (the trainee) can visualize the airway during the procedure, preventing simultaneous observation by the instructor. While video laryngoscopes (VL), such as the GlideScope®, offer a screen-based view that allows for shared visualization and potentially reduced physical exposure to respiratory secretions, their high cost and the lack of definitive comparative data on their efficacy in educational settings (as opposed to clinical outcomes) necessitate further investigation. This study aimed to determine if the GlideScope® offers a statistically significant advantage over the conventional direct laryngoscope for teaching intubation to novice medical students.

Methodology
This was a randomized interventional study conducted at Shahid Sadoughi University of Medical Sciences involving 42 fifth-year medical students with no prior formal intubation training.

Design: Participants were randomly assigned (1:1 ratio) to two groups: the GlideScope® video laryngoscopy group ( $n=21$ ) and the conventional direct laryngoscopy (DL) group ( $n=21$ ).
Procedure: Following standardized theoretical instruction, all participants performed five consecutive endotracheal intubation attempts on a Laerdal Airway Management Trainer mannequin.
- The DL group used a Macintosh size 3 blade.
- The GlideScope® group used a GVL video laryngoscope.
Metrics:
- Primary Outcome: Intubation success (number of successful attempts out of five).
- Secondary Outcomes: Intubation performance speed (time from blade insertion to tube passage) and student satisfaction (5-point scale).
Analysis: Statistical analysis included independent-samples t-tests, chi-square tests, and repeated measures ANOVA to evaluate learning curves and interactions between time, method, gender, and baseline knowledge.

Key Results

Success Rates: Both methods demonstrated high overall success rates. The GlideScope® group achieved a 95% success rate, while the DL group achieved 90%. While the GlideScope® group had a higher proportion of students achieving a perfect 5/5 success score (61.9% vs. 38.1%), this difference was not statistically significant ( $p=0.451$ ).
Learning Curve: Both groups showed progressive improvement in intubation speed across the five attempts. There was no significant interaction between time and teaching method ( $p=0.841$ ), indicating that the rate of skill acquisition was comparable for both devices.
Satisfaction: Student satisfaction was generally high in both groups. The GlideScope® group reported higher "Excellent" ratings (81% vs. 57.1%), but the difference was not statistically significant ( $p=0.247$ ).
Subgroup Analysis: No significant interactions were found regarding gender ( $p=0.489$ ) or baseline knowledge levels ( $p=0.867$ ). Both male and female students, as well as those with varying levels of prior theoretical knowledge, improved at similar rates regardless of the device used.

Key Contributions

Comparative Efficacy: The study provides empirical evidence that for novice medical students, the GlideScope® video laryngoscope and the conventional direct laryngoscope are equally effective tools for teaching the fundamental mechanics of endotracheal intubation.
Educational Context: Unlike many studies focusing on clinical patient outcomes, this research isolates the training phase, demonstrating that while video laryngoscopy offers visual advantages (simultaneous viewing), these do not translate into statistically superior skill acquisition or speed in a controlled simulator environment for beginners.
Demographic Neutrality: The findings suggest that neither gender nor baseline theoretical knowledge significantly influences the learning curve for either device, supporting the equitable use of both methods across diverse student populations.

Significance and Claims
The paper concludes that both the GlideScope® and direct laryngoscopy are viable, effective methods for teaching intubation. While the authors acknowledge descriptive trends favoring the GlideScope®—specifically higher rates of perfect success and satisfaction—they explicitly state these differences were not statistically significant.

The study posits that the choice of device in an educational curriculum should be driven by resource availability and specific educational goals rather than a presumed superiority of one technology over the other for basic skill acquisition. The authors suggest that the video laryngoscope's potential advantages (such as shared viewing and reduced exposure to secretions) make it a strong candidate for the post-pandemic era, but they caution that its high cost must be weighed against the finding that it does not significantly outperform the gold-standard direct laryngoscope in terms of raw skill acquisition for novices. The paper calls for future research with larger sample sizes and long-term follow-up to further elucidate these findings.

Technical Summary: Comparing Direct and Video Laryngoscopy Training for Medical Students

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