BACKGROUND: Failure in airway management continues to cause preventable patient harm, and the recommended continuing education is challenged by anaesthesiologists´ unknown knowledge gaps. This study aimed to identify anaesthesiologists´ subjective and objective knowledge gaps as well as areas where anaesthesiologists are incorrect and unaware.

METHODS: An adaptive E-learning programme with 103 questions on adult airway management was used for subjective and objective assessment of anaesthesiologists´ knowledge. All anaesthesiologists in the Capital Region of Denmark were invited to participate.

RESULTS: The response rate was 67% (191/285). For preoperative planning, participants stated low confidence (subjective assessment) regarding predictors of difficult airway management in particular (69.1-79.1%). Test scores (objective assessment) were lowest for obstructive sleep apnoea as a predictor of difficult airway management (28.8% correct), with participants being incorrect and unaware in 33.5% of the answers. For optimisation of basic techniques, the lowest confidence ratings related to patient positioning and prediction of difficulties (57.4-83.2%), which agreed with the lowest test scores. Concerning advanced techniques, videolaryngoscopy prompted the lowest confidence (72.4-85.9%), while emergency cricothyrotomy resulted in the lowest test scores (47.4-67.8%). Subjective and objective assessments correlated and lower confidence was associated with lower test scores: preoperative planning [r = -0.58, P < 0.001], optimisation of basic techniques [r = -0.58, P = 0.002], and advanced techniques [r = -0.71, P < 0.001].

CONCLUSION: We identified knowledge gaps in important areas of adult airway management with differing findings from the subjective and objective assessments. This underlines the importance of objective assessment to guide continuing education.

Original languageEnglish
JournalActa Anaesthesiologica Scandinavica
Issue number1
Pages (from-to)58-67
Number of pages10
Publication statusPublished - Jan 2021


  • adaptive E-learning
  • airway management
  • competence
  • continuing education
  • continuing professional development
  • expertise
  • self-assessment
  • testing


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