We have recently conducted a simi-lar pilot study to that reported byFriedman et al. [1, 2], with the aimof exploring how Core Trainee(CT) anaesthetists (one to two yearsof anaesthetic experience) challengea consultant anaesthetist within afully immersive ‘can’t intubate, can ’tventilate’ simulation.Thirteen CT1 and CT2 traineeanaesthetists were asked to challengedecisions made by a consultantanaesthetist acting out an inabilityto intubate the trachea after rapidsequence induction, who subse-quently loses situational awarenessand becomes ?xated on the act ofintubation, resulting in failure toventilate and oxygenate despite sim-ulated patient oxygen desaturation.Challenges were observed and asemi-structured debrief undertaken,using a video of the scenario. Thetime to the ?rst challenge, the num-ber of tracheal intubation attemptsbefore challenge, and the time toestablish an airway using a rescuelaryngeal mask were recorded . Thenumber, type (verba l or non-verbal )and grade [1-5, [3]) of challengewere recorded.Results of this pilot study indicatedthat progression to a correctly poweredstudy was merited. Senior trainees chal-lenged authority more effectively, andused more verbal and non-verbal com-munication when challenging, forexample removing the laryngoscopefrom the consultant’s hand, obstructingthe consultant from further intubationattempts and using hand gestures.
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