{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T23:55:46Z","timestamp":1790898946483,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Flexible laryngeal mask airway (fLMA) management is an important but technically demanding airway skill, particularly for novice physicians. Distance hands\u2010on training may provide a scalable alternative when access to face\u2010to\u2010face simulation is limited, but evidence demonstrating transfer of such training to clinical performance in patients remains scarce. This trial aims to compare distance hands\u2010on training with standardized video instruction for novice physicians learning fLMA management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a prospective, multicenter, parallel\u2010group, rater\u2010blinded, superiority randomized controlled trial conducted at three tertiary hospitals in China. Thirty novice physician participants will be randomized 1:1 to either distance hands\u2010on training or video instruction. Both groups will receive identical standardized theoretical materials, a procedural demonstration video, and a written checklist. The distance hands\u2010on training group will additionally receive remotely supervised deliberate practice using an airway task trainer with real\u2010time instructor feedback. After training, each physician participant will perform fLMA management in two adult patient participants under direct supervision by experienced anesthesiologists. Clinical performance will be video\u2010recorded and independently assessed by two blinded raters using the Flexible LMA Airway Management Global Rating Scale, for which validity evidence was established in a preceding study. Secondary outcomes include procedural success, insertion time, ventilation parameters, fLMA positioning, procedure\u2010related complications, learning progression, and physician participant satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This trial will evaluate whether structured distance hands\u2010on training improves clinical procedural performance beyond standardized video instruction. By combining randomized educational intervention, multicenter clinical assessment, blinded video\u2010based rating, and patient\u2010based outcome evaluation, the study aims to provide evidence on the transfer of distance simulation training to clinical airway management.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      Chinese Clinical Trial Registry (ChiCTR): ChiCTR2600121867\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.70348","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T23:26:41Z","timestamp":1790897201000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distance Hands\u2010On Training Versus Video Instruction for Flexible Laryngeal Mask Airway Management: A Protocol for a Multicenter Randomized Controlled Trial"],"prefix":"10.1111","volume":"70","author":[{"given":"Wei","family":"Wei","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Eye &amp; ENT Hospital of Fudan University  Shanghai China"},{"name":"Copenhagen Academy for Medical Education and Simulation (CAMES) Center for HR &amp; Education, the Capital Region of Denmark  Copenhagen Denmark"},{"name":"Department of Clinical Medicine Rigshospitalet, Capital Region of Denmark  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9462-1665","authenticated-orcid":false,"given":"Michael Seltz","family":"Kristensen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Centre of Head and Orthopedics, Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1133-8560","authenticated-orcid":false,"given":"Wenxian","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Eye &amp; ENT Hospital of Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders Bo","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Odense University Hospital  Svendborg Denmark"},{"name":"Research Unit of Medical Education, Department of Clinical Research University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7352-8728","authenticated-orcid":false,"given":"Lene","family":"Russell","sequence":"additional","affiliation":[{"name":"Copenhagen Academy for Medical Education and Simulation (CAMES) Center for HR &amp; Education, the Capital Region of Denmark  Copenhagen Denmark"},{"name":"Department of Clinical Medicine Rigshospitalet, Capital Region of Denmark  Copenhagen Denmark"},{"name":"Department of Intensive Care Copenhagen University Hospital Herlev\u2010Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Konge","sequence":"additional","affiliation":[{"name":"Copenhagen Academy for Medical Education and Simulation (CAMES) Center for HR &amp; Education, the Capital Region of Denmark  Copenhagen Denmark"},{"name":"Department of Clinical Medicine Rigshospitalet, Capital Region of Denmark  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4619-2426","authenticated-orcid":false,"given":"Yuan","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Eye &amp; ENT Hospital of Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"e_1_2_28_2_1","first-page":"5","article-title":"The Development of the Laryngeal Mask\u2014A Brief History of the Invention, Early Clinical Studies and Experimental Work From Which the Laryngeal Mask Evolved","volume":"4","author":"Brain A. 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