{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T02:53:42Z","timestamp":1792551222267,"version":"4.5.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007210","name":"RWTH Aachen University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007210","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Direct laryngoscopy (DL) is a crucial skill and continues to be indispensable. While the superiority of video laryngoscopy (VL) has been demonstrated regarding the rate of first attempt successful intubations, its application as a teaching tool for DL remains largely unexplored. We hypothesised a higher first-pass success and shorter durations of conventional intubation after video laryngoscopy supported training (VLF\u2009=\u2009video-laryngoscopy based feedback) compared to students trained without VL (DLF\u2009=\u2009direct-laryngoscopy based feedback).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All 211 medical students (DLF: 92\/ VLF:119) trained conventional intubation, using a manikin in an airway course during their anaesthesiology rotation in fourth year of medical school. The study period was October 2023 to August 2024. In the DLF group, the tutor could only provide feedback via an intermittent direct view of the larynx during intubation whereas in the VLF group, the tutor had a continuous view via the monitor. Students of the VLF group did not get a view of the monitor and performed laryngoscopy via direct view. The main outcome measures were the first-pass success, time for intubation, Cormack-Lehane Score, occurrence of tooth damage, a difficulty score and a self-confidence score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both groups achieved a high rate of first-pass success (DLF 97,8% vs. VLF 100%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.081). Nevertheless, we found a significant difference concerning duration of intubation (DLF 21,49s\u2009\u00b1\u20097,421 vs. VLF 24,75s\u2009\u00b1\u200910,371,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). DLF group demonstrated a higher reduction in a subjective difficulty score (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). Both groups demonstrated enhanced confidence regarding airway management following training favouring DLF group (difference between the groups:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Teaching direct laryngoscopy by using the video laryngoscope monitor as a teaching tool for the tutor seems to give students more detailed feedback and a more realistic rating of the difficulty level, which is reflected in the students spending more time on the task, a smaller decrease in the difficulty value and a more realistic self-assessment. Furthermore, a higher first-pass success in our assessment with direct laryngoscopy is reached after video-laryngoscopy based feedback training. We assume that this method holds great chances for teaching practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      DRKS00032815\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/drks.de\/search\/de\/trial\/DRKS00032815\" ext-link-type=\"uri\">https:\/\/drks.de\/search\/de\/trial\/DRKS00032815<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12909-026-08889-2","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T13:24:11Z","timestamp":1771939451000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Video laryngoscopy as a teaching tool in direct intubation in undergraduate medical education \u2013 a randomized controlled trial"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7131-8300","authenticated-orcid":false,"given":"Daniel","family":"Uhing","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Vogt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Klasen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"Elissen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico","family":"Haehn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasa","family":"Sopka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Tobias","family":"Schauwinhold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"8889_CR1","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1111\/j.1399-6576.2011.02547.x","volume":"56","author":"M Bernhard","year":"2012","unstructured":"Bernhard M, Mohr S, Weigand MA, et al. Developing the skill of endotracheal intubation: implication for emergency medicine. Acta Anaesthesiol Scand. 2012;56:164\u201371.","journal-title":"Acta Anaesthesiol Scand"},{"key":"8889_CR2","first-page":"316","volume":"60","author":"A Timmermann","year":"2019","unstructured":"Timmermann A, B\u00f6ttiger BW, Byhahn C, et al. S1-Leitlinie: Pr\u00e4hospitales Atemwegsmanagement. An\u00e4sth Intensivmed. 2019;60:316\u201336.","journal-title":"An\u00e4sth Intensivmed"},{"key":"8889_CR3","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.resuscitation.2015.11.005","volume":"99","author":"ML Buis","year":"2016","unstructured":"Buis ML, Maissan IM, Hoeks SE, et al. Defining the learning curve for endotracheal intubation using direct laryngoscopy: A systematic review. Resuscitation. 2016;99:63\u201371.","journal-title":"Resuscitation"},{"issue":"5","key":"8889_CR4","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1056\/NEJMoa2301601","volume":"389","author":"ME Prekker","year":"2023","unstructured":"Prekker ME, Driver BE, Trent SA, et al. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. N Engl J Med. 2023;389(5):418\u201329.","journal-title":"N Engl J Med"},{"issue":"4","key":"8889_CR5","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1016\/j.bja.2022.05.027","volume":"129","author":"J Hansel","year":"2022","unstructured":"Hansel J, Rogers AM, Lewis SR, et al. Videolaryngoscopy versus direct laryngoscopy for adults undergoing tracheal intubation: a Cochrane systematic review and meta-analysis update. Br J Anaesth. 2022;129(4):612\u201323.","journal-title":"Br J Anaesth"},{"key":"8889_CR6","doi-asserted-by":"publisher","first-page":"100297","DOI":"10.1016\/j.resplu.2022.100297","volume":"11","author":"L Cox","year":"2022","unstructured":"Cox L, Tebbett A. Videolaryngoscopy versus direct laryngoscopy for endotracheal intubation of cardiac arrest patients in hospital: A systematic literature review. Resusc Plus. 2022;11:100297.","journal-title":"Resusc Plus"},{"issue":"5","key":"8889_CR7","first-page":"CD009975","volume":"5","author":"K Lingappan","year":"2023","unstructured":"Lingappan K, Neveln N, Arnold JL, et al. Videolaryngoscopy versus direct laryngoscopy for tracheal intubation in neonates. Cochrane Database Syst Rev. 2023;5(5):CD009975.","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"8889_CR8","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1097\/ALN.0b013e318246ea34","volume":"116","author":"MF Aziz","year":"2012","unstructured":"Aziz MF, Dillman D, Fu R, et al. Comparative effectiveness of the C-MAC video laryngoscope versus direct laryngoscopy in the setting of the predicted difficult airway. Anesthesiology. 2012;116(3):629\u201336.","journal-title":"Anesthesiology"},{"issue":"4","key":"8889_CR9","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1007\/s12630-020-01908-w","volume":"68","author":"R Howle","year":"2021","unstructured":"Howle R, Onwochei D, Harrison SL, et al. Comparison of videolaryngoscopy and direct laryngoscopy for tracheal intubation in obstetrics: a mixed-methods systematic review and meta-analysis. Can J Anaesth. 2021;68(4):546\u201365.","journal-title":"Can J Anaesth"},{"issue":"5","key":"8889_CR10","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1093\/bja\/aex344","volume":"119","author":"R Park","year":"2017","unstructured":"Park R, Peyton JM, Fiadjoe JE, et al. The efficacy of GlideScope\u00ae videolaryngoscopy compared with direct laryngoscopy in children who are difficult to intubate: an analysis from the paediatric difficult intubation registry. Br J Anaesth. 2017;119(5):984\u201392.","journal-title":"Br J Anaesth"},{"issue":"3","key":"8889_CR11","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1007\/s00268-014-2845-z","volume":"39","author":"M Michailidou","year":"2015","unstructured":"Michailidou M, O\u2019Keeffe T, Mosier JM, et al. A comparison of video laryngoscopy to direct laryngoscopy for the emergency intubation of trauma patients. World J Surg. 2015;39(3):782\u20138.","journal-title":"World J Surg"},{"key":"8889_CR12","doi-asserted-by":"crossref","unstructured":"Lewis SR, Butler AR, Parker J. Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation. Cochrane Database Syst Rev. 2016; 11(11):CD011136. Update in: Cochrane Database Syst Rev. 2022; 4:CD011136.","DOI":"10.1002\/14651858.CD011136.pub2"},{"key":"8889_CR13","doi-asserted-by":"crossref","unstructured":"Cabrini L, Landoni G, Baiardo Redaelli M et al. Tracheal intubation in critically ill patients: a comprehensive systematic review of randomized trials. Crit Care. 2018; 22(1):6. Erratum in: Crit Care. 2019; 23(1):325.","DOI":"10.1186\/s13054-017-1927-3"},{"issue":"3","key":"8889_CR14","doi-asserted-by":"publisher","first-page":"169","DOI":"10.4103\/ija.ija_234_22","volume":"66","author":"SN Myatra","year":"2022","unstructured":"Myatra SN, Patwa A, Divatia JV. Videolaryngoscopy for all intubations: Is direct laryngoscopy obsolete? Indian J Anaesth. 2022;66(3):169\u201373.","journal-title":"Indian J Anaesth"},{"issue":"8","key":"8889_CR15","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1007\/s00101-025-01557-y","volume":"74","author":"G Massoth","year":"2025","unstructured":"Massoth G, Dinc T, Wittmann M, et al. Value of video laryngoscopy as universal primary intubation technique for anesthesiological practice: Narrative review. Anaesthesiologie. 2025;74(8):518\u201325.","journal-title":"Anaesthesiologie"},{"issue":"2","key":"8889_CR16","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1002\/lary.26134","volume":"127","author":"D Greer","year":"2017","unstructured":"Greer D, Marshall KE, Bevans S, et al. Review of videolaryngoscopy pharyngeal wall injuries. Laryngoscope. 2017;127(2):349\u201353.","journal-title":"Laryngoscope"},{"key":"8889_CR17","unstructured":"Piepho, et al. S1-Leitlinie Atemwegsmanagement. AWMF; 2023."},{"issue":"5","key":"8889_CR18","doi-asserted-by":"publisher","first-page":"300060521101674","DOI":"10.1177\/03000605211016740","volume":"49","author":"IK Yi","year":"2021","unstructured":"Yi IK, Hwang J, Min SK, et al. Comparison of learning direct laryngoscopy using a McGrath videolaryngoscope as a direct versus indirect laryngoscope: a randomized controlled trial. J Int Med Res. 2021;49(5):3000605211016740.","journal-title":"J Int Med Res"},{"issue":"2","key":"8889_CR19","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1111\/j.1365-2044.2007.05323.x","volume":"63","author":"D Low","year":"2008","unstructured":"Low D, Healy D, Rasburn N. The use of the BERCI DCI Video Laryngoscope for teaching novices direct laryngoscopy and tracheal intubation. Anaesthesia. 2008;63(2):195\u2013201.","journal-title":"Anaesthesia"},{"issue":"7","key":"8889_CR20","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1111\/j.1365-2044.2010.06335.x","volume":"65","author":"CM Ayoub","year":"2010","unstructured":"Ayoub CM, Kanazi GE, Al Alami A, et al. Tracheal intubation following training with the GlideScope compared to direct laryngoscopy. Anaesthesia. 2010;65(7):674\u20138.","journal-title":"Anaesthesia"},{"issue":"1","key":"8889_CR21","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1097\/EJA.0000000000001928","volume":"41","author":"N Disma","year":"2024","unstructured":"Disma N, Asai T, Cools E, et al. Airway management in neonates and infants: European Society of Anaesthesiology and Intensive Care and British Journal of Anaesthesia joint guidelines. Eur J Anaesthesiol. 2024;41(1):3\u201323.","journal-title":"Eur J Anaesthesiol"},{"key":"8889_CR22","doi-asserted-by":"crossref","unstructured":"Doyle D. The GlideScope Video Laryngoscope: A Narrative Review. Open Anaesthesiol J. 2017;11(1):48\u201367.","DOI":"10.2174\/1874321801711010048"},{"key":"8889_CR23","doi-asserted-by":"publisher","first-page":"c332","DOI":"10.1136\/bmj.c332","volume":"340","author":"KF Schulz","year":"2010","unstructured":"Schulz KF, Altman DG, Moher D, Group CONSORT. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332.","journal-title":"BMJ"},{"key":"8889_CR24","unstructured":"Walker M, Peyton JW. R. Teaching in theatre. Teaching and learning in medical practice. Rickmansworth, UK: Manticore Europe Limited. 1998; 171\u2013180."},{"issue":"3","key":"8889_CR25","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1213\/00000539-199803000-00037","volume":"86","author":"C Konrad","year":"1998","unstructured":"Konrad C, Sch\u00fcpfer G, Wietlisbach M, et al. Learning manual skills in anesthesiology: Is there a recommended number of cases for anesthetic procedures? Anesth Analg. 1998;86(3):635\u20139.","journal-title":"Anesth Analg"},{"issue":"1","key":"8889_CR26","doi-asserted-by":"publisher","first-page":"14903","DOI":"10.1038\/s41598-022-19337-8","volume":"12","author":"GT Lee","year":"2022","unstructured":"Lee GT, Park JE, Woo SY, et al. Defining the learning curve for endotracheal intubation in the emergency department. Sci Rep. 2022;12(1):14903.","journal-title":"Sci Rep"},{"key":"8889_CR27","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12055","volume-title":"The Importance of First Pass Success When Performing Orotracheal Intubation in the Emergency Department","author":"Sakles","year":"2013","unstructured":"Sakles, et al. The Importance of First Pass Success When Performing Orotracheal Intubation in the Emergency Department. Emergency Medicine: Academic; 2013."},{"issue":"2","key":"8889_CR28","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1213\/01.ANE.0000122825.04923.15","volume":"99","author":"TC Mort","year":"2004","unstructured":"Mort TC. Emergency tracheal intubation: complications associated with repeated laryngoscopic attempts. Anesth Analg. 2004;99(2):607\u201313. table of contents.","journal-title":"Anesth Analg"},{"issue":"6","key":"8889_CR29","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1016\/j.annemergmed.2012.04.005","volume":"60","author":"K Hasegawa","year":"2012","unstructured":"Hasegawa K, Shigemitsu K. Hagiwara Yet al. Japanese Emergency Medicine Research Alliance Investigators. Association between repeated intubation attempts and adverse events in emergency departments: an analysis of a multicenter prospective observational study. Ann Emerg Med. 2012;60(6):749\u2013e7542.","journal-title":"Ann Emerg Med"},{"issue":"3","key":"8889_CR30","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1213\/ANE.0b013e3182222a66","volume":"113","author":"F Herbstreit","year":"2011","unstructured":"Herbstreit F, Fassbender P, Haberl H, et al. Learning endotracheal intubation using a novel videolaryngoscope improves intubation skills of medical students. Anesth Analg. 2011;113(3):586\u201390.","journal-title":"Anesth Analg"},{"issue":"8","key":"8889_CR31","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1111\/anae.16250","volume":"79","author":"M Kriege","year":"2024","unstructured":"Kriege M, Lang P, Lang C, et al. A comparison of the McGrath videolaryngoscope with direct laryngoscopy for rapid sequence intubation in the operating theatre: a multicentre randomised controlled trial. Anaesthesia. 2024;79(8):801\u20139.","journal-title":"Anaesthesia"},{"issue":"1","key":"8889_CR32","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1186\/s12909-024-05439-6","volume":"24","author":"J Fuentes-Cimma","year":"2024","unstructured":"Fuentes-Cimma J, Sluijsmans D, Riquelme A, et al. Designing feedback processes in the workplace-based learning of undergraduate health professions education: a scoping review. BMC Med Educ. 2024;24(1):440.","journal-title":"BMC Med Educ"}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12909-026-08889-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-026-08889-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-026-08889-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:47:26Z","timestamp":1781635646000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12909-026-08889-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,24]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8889"],"URL":"https:\/\/doi.org\/10.1186\/s12909-026-08889-2","relation":{},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,24]]},"assertion":[{"value":"22 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval for this study (Ethical Committee 028\/22) was provided by the Ethical Committee of the University Hospital, RWTH Aachen, Germany (Chairperson: Prof. Dr. Dr. Dr. D. Gro\u00df) on 28 January 2022. According to this ethic approval a written informed consent was not necessary. All participants were informed of the ongoing study and could resign at every time. This study was designed according to the ethical principles of the World Medical Association\u2019s Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"363"}}