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Tracheal IntubationPACTNCT07146984

Application of PDCA Cycle in Tracheal Intubation Training for Emergency Medicine Residents

An observational study of Tracheal Intubation and Medical Education, run by Guangzhou Panyu Central Hospital at 1 site in China.

Enrolling by invitation

Enrolling by invitation. The study team selects and invites participants, usually from an existing group of patients.

Sites and contacts
Official record
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Trial summary

Tracheal intubation is a critical but technically demanding procedure in emergency airway management. Junior emergency medicine residents often struggle to achieve proficiency, leading to increased risks of complications. Read more about this study

Who is it for?
Ages 25 to 45 years
Conditions the study is for
Tracheal Intubation, Medical Education
What is being tested?
Behavioral (Educational Training Program)
How many people
100 participants
Where
1 siteChina
Study dates
1 Oct 2024to 30 Sep 2025
How long will I take part?
6 Months
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 25 to 45 years
  • All sexes
  • No healthy volunteers
  • Adult

Study population: Emergency medicine residents from the Department of Emergency, Panyu Central Hospital, Guangzhou Medical University, China. Participants were postgraduate residents rotating in the emergency department during the study period and were required to perform tracheal intubation as part of their clinical training.

Who may be able to join

  • Emergency medicine residents rotating in the emergency department during the study period.
  • Residents who are required to perform tracheal intubation as part of clinical training.
  • Residents who have completed baseline theoretical and simulation-based airway management training.
  • Voluntary participation with written informed consent.

Who cannot join

  • • Residents who refuse to participate or withdraw consent.
  • Residents with prior advanced airway fellowship training or extensive intubation experience (>50 independent intubations).
  • Residents who are unable to complete the full PDCA-based training program due to absence or rotation schedule.
  • Any medical condition or circumstance deemed by investigators to interfere with participation or data integrity.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

China1 site
  • The Affiliated Panyu Central Hospital, Guangzhou Medical University

    Guangzhou, Guangdong, 511000

Other trials in China

About this study

Tracheal intubation is a critical but technically demanding procedure in emergency airway management. Junior emergency medicine residents often struggle to achieve proficiency, leading to increased risks of complications. This study evaluates the effectiveness of a Plan-Do-Check-Act (PDCA) cycle-based training program in improving intubation skills.

The study was conducted in the emergency department of a tertiary teaching hospital. Residents performing intubations in 2023 with conventional training served as the control group, while those trained with the PDCA model in 2024 formed the intervention group. The PDCA program included structured lectures, high-fidelity simulation, supervised clinical practice, and iterative feedback.

Primary outcomes were first-attempt success rate and intubation completion time. Secondary outcomes included incidence of local airway trauma, extubation failure due to airway injury within 72 hours, and resident satisfaction. This study aims to provide evidence that PDCA-based training can enhance procedural competency, safety, and learner satisfaction in emergency airway management.

Read the detailed description

Tracheal intubation is a high-risk, time-sensitive procedure that is fundamental to emergency airway management. Despite its lifesaving role, it remains one of the most technically challenging skills for junior emergency medicine residents. Failed or delayed intubation is associated with serious complications, including airway trauma, hypoxemia, aspiration, and cardiac arrest. Traditional didactic training often lacks the iterative practice and structured feedback required for durable skill acquisition.

The Plan-Do-Check-Act (PDCA) cycle is an educational quality improvement framework that emphasizes continuous evaluation, feedback, and refinement. This study was designed to investigate whether a PDCA-based training model could improve intubation competency among emergency medicine residents in a tertiary teaching hospital.

This prospective observational study compared intubation performance before and after PDCA cycle implementation. The control group included residents performing intubations in 2023 with conventional training, while the intervention group included residents trained with the PDCA model in 2024. The PDCA program consisted of structured didactic sessions, high-fidelity simulation, supervised clinical practice, and iterative debriefing with continuous feedback loops.

Primary outcomes were first-attempt success rate and intubation completion time, as these are widely recognized benchmarks of procedural safety and efficiency. Secondary outcomes included the incidence of local airway trauma, extubation failure due to airway injury within 72 hours, and resident satisfaction with training.

We hypothesized that PDCA-based training would significantly improve first-pass success, shorten intubation time, reduce airway-related complications, and enhance trainee satisfaction. The findings may provide evidence for adopting structured, feedback-oriented frameworks in emergency and critical care training, with broader implications for competency-based medical education.

Being tested
Behavioral (Educational Training Program)
Keywords
PDCA cycle, emergency medicine, tracheal intubation, medical education

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Behavioral (Educational Training Program)Behavioural

    A structured training program for emergency medicine residents based on the Plan-Do-Check-Act (PDCA) cycle. The intervention includes didactic teaching, simulation-based airway management practice, supervised clinical intubation, iterative performance assessment, and feedback-driven improvement.

Study groups in NCT07146984
Study groupRoleWhat they receive
PDCA Cycle-Based Training InterventionThe Plan-Do-Check-Act (PDCA) cycle Based Training Intervention
Receives: Behavioral: Behavioral (Educational Training Program)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. First-Attempt Success Rate of Tracheal Intubation

    The proportion of tracheal intubation attempts by emergency medicine residents successfully completed on the first attempt, as verified by standard clinical confirmation (e.g., chest rise, end-tidal CO₂, auscultation, chest X-ray).

    Measured: Within procedure (immediately at time of intubation)

Secondary outcomes (4)
  1. Intubation Completion Time

    Time in seconds from insertion of the laryngoscope to confirmation of successful tube placement.

    Measured: Periprocedural (measured once during each intubation attempt, from laryngoscope insertion to confirmed tracheal tube placement, using a stopwatch

  2. Incidence of Local Airway Trauma

    Presence of fresh blood in the airway post-intubation, excluding bleeding from preexisting conditions (e.g, subglottic mass, pulmonary hemorrhage).

    Measured: Assessment was performed immediately after completion of intubation and within 5 minutes post-procedure, by direct laryngoscopic visualization or suction catheter inspection

  3. Extubation Failure Due to Airway Injury

    Reintubation within 72 h despite meeting extubation criteria, confirmed by laryngoscopy (e.g., edema, vocal cord paralysis, granulation, or subglottic stenosis).

    Measured: Assessment was performed within 72 hours following planned extubation. Patients were monitored for the need of reintubation, and airway injury was confirmed by laryngoscopy when extubation failure occurred.

  4. Mean Questionnaire Score on Learning Experience and Perceived Training Value

    Assessed via anonymous questionnaire administered immediately after training。Scores are reported on a 5-point Likert scale (1 = very poor, 5 = excellent), with higher scores indicating a better learning experience and greater perceived training value.

    Measured: Immediately after completion of the training session (within 24 hours).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Aug 2025
  2. Study start1 Oct 2024
  3. Primary completion30 Sep 2025 (estimated)
  4. Study completion30 Sep 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
100 participants (estimated)
Target duration
6 Months
IDs, dates and publications
ClinicalTrials.gov ID
NCT07146984
Sponsor's protocol ID
PYRC-2024-280-01
Acronym
PACT
Status last verified
Sep 2025
First submitted
16 Aug 2025
Last updated
22 Sep 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Tracheal Intubation and Medical Education, run by Guangzhou Panyu Central Hospital at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: enrolling by invitation, as of the sponsor's last update on 22 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

First-Attempt Success Rate of Tracheal Intubation (time frame: Within procedure (immediately at time of intubation)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Sep 2025.

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