Self-Confidence in Endotracheal Intubation Among Pediatric Interns: Associations with Gender, Experience, and Performance

BACKGROUND Supervisors' decisions regarding procedural readiness are influenced by resident confidence. Confidence is a valuable metric if we understand how it correlates with trainee characteristics and procedural competence. OBJECTIVE Evaluate the relationship between self-reported confidence in endotracheal intubation (ETI) and pediatric interns' characteristics (gender, prior intubation experience) and performance (airway management knowledge, demonstrated skills on airway trainers). METHODS This was a secondary analysis of a randomized, controlled trial of an airway management curriculum. Gender and prior intubation experience were reported on a pre-participation questionnaire. Interns' performance was measured: 1) using a 14-item knowledge-based assessment of airway management and 2) as time to successful intubation across 4 simulated intubation scenarios. After completing the curriculum and assessment, interns reported retrospective pre-curriculum and current post-curriculum confidence with ETI using a 10-point Likert scale. RESULTS Forty-nine interns participated, of whom 16 (33%) were male. Eleven (22%) had ≥1 previous successful intubation. Median [interquartile range] pre- and post-curriculum confidence scores were 3 [2, 5] and 6 [5, 8], respectively. Male interns reported higher pre-curriculum confidence than females (median difference: 2.0; 95% confidence interval: 0.1, 3.9); post-curriculum confidence among males was also higher but not statistically significant. There was no correlation between self-reported pre-curriculum confidence and prior experience. There was no correlation between pre- or post-curriculum self-reported confidence and performance on the knowledge-based assessment or time to successful intubation on airway trainers. CONCLUSION Male pediatric interns self-report higher initial confidence in ETI compared to females. Self-reported confidence did not correlate with prior experience, airway management knowledge, or intubation performance on airway trainers.