Effect of Instructional Format on Veterinary Students' Task Performance and Emotional State during a Simulation-Based Canine Endotracheal Intubation Laboratory: Handout versus Video.

Video- versus handout-based instructions may influence student outcomes during simulation training and competency-based assessments. Forty-five third-year veterinary students voluntarily participated in a simulation module on canine endotracheal intubation. A prospective, randomized, double-blinded study investigated the impact of video (n = 23) versus handout (n = 22) instructions on student confidence, anxiety, and task performance. Students self-scored their confidence and anxiety before and after the simulation. During the simulation laboratory, three raters independently evaluated student performance using a 20-item formal assessment tool with a 5-point global rating scale. No significant between- or within-group differences (p > .05) were found for both confidence and anxiety scores. Video-based instructions were associated with significantly higher (p < .05) total formal assessment scores compared with handout-based instructions. The video group had significantly higher scores than the handout group on 3 of the 20 individual skills (items) assessed: placement of tie to the adaptor-endotracheal tube complex (p < .05), using the anesthetic machine (p < .01), and pop-off valve management (p < .001). Inter-rater reliability as assessed by Cronbach's alpha (.92), and Kendall's W (.89) was excellent and almost perfect, respectively. A two-faceted crossed-design generalizability analysis yielded G coefficients for both the handout (E-p(2) = .68) and the video (E-p(2) = .72) groups. Video instructions may be associated with higher performance scores than handout instructions during endotracheal intubation simulation training. Further research into skill retention and learning styles is warranted.