Experiential learning improves the learning and retention of endotracheal intubation Lian K Ti, 1,2 Fun-Gee Chen, 1,2 Gee-Mei Tan, 3 Wah-Tze Tan, 2 Jacqueline M J Tan, 1 Liang Shen 1 & Raymond W L Goy 2 CONTEXT Simulators provide an effective platform for the learning of clinical motor skills such as endotracheal intubation, although the optimal learning technique remains unidenti- fied. We hypothesised that, for novices, experiential learning would improve the learning and retention of endotracheal intubation compared with guided learning. METHODS Year 4 medical students were randomised to either guided or experiential learning. Students in the guided group were taught using the conventional step-by-step technique. Students in the experiential group had to work out the correct technique for intu- bation on their own. Both groups had further opportunities to intubate manikins and patients during their postings. The students were recalled 3, 6, 9 and 12 months later, and their intubation skills assessed in four major categories: equip- ment preparation; intubation technique; suc- cessful intubation, and placement confirmation. RESULTS A total of 210 students (107 guided, 103 experiential) participated in the study. At 3 months, 64.5% of the students in the expe- riential group successfully intubated the mani- kin, compared with 36.9% in the guided group (P < 0.001). The experiential group also had higher overall scores, signifying quality of intu- bation attempts, at 3 months (79% versus 70%; P < 0.001). Success rates and overall scores for both groups were comparable at 6 and 9 months, but were better in the experiential group at 12 months. Success rates improved with time, reaching 86% at 12 months. CONCLUSIONS Novices learned and retained the skill of endotracheal intubation better with experiential learning. This study suggests that experiential learning should be adopted for the teaching of endotracheal intubation and that refresher tuition at 3-monthly intervals will prevent the decay of this skill in infrequent users. simulations Medical Education 2009: 43: 654–660 doi:10.1111/j.1365-2923.2009.03399.x 1 Department of Anaesthesia, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 2 Department of Anaesthesia, National University Hospital, Singapore 3 Department of Anesthesiology, The Children’s Hospital, University of Colorado Denver School of Medicine, Colorado, USA Correspondence: Lian K Ti, MMed, Department of Anaesthesia, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore. Tel: 00 65 9821 7691; Fax: 00 65 6777 5702; E-mail: anatilk@nus.edu.sg 654 ª Blackwell Publishing Ltd 2009. MEDICAL EDUCATION 2009; 43: 654–660