Distance Hands‐On Training Versus Video Instruction for Flexible Laryngeal Mask Airway Management: A Protocol for a Multicenter Randomized Controlled Trial

Background Flexible laryngeal mask airway (fLMA) management is an important but technically demanding airway skill, particularly for novice physicians. Distance hands‐on training may provide a scalable alternative when access to face‐to‐face simulation is limited, but evidence demonstrating transfer of such training to clinical performance in patients remains scarce. This trial aims to compare distance hands‐on training with standardized video instruction for novice physicians learning fLMA management. Methods This is a prospective, multicenter, parallel‐group, rater‐blinded, superiority randomized controlled trial conducted at three tertiary hospitals in China. Thirty novice physician participants will be randomized 1:1 to either distance hands‐on training or video instruction. Both groups will receive identical standardized theoretical materials, a procedural demonstration video, and a written checklist. The distance hands‐on training group will additionally receive remotely supervised deliberate practice using an airway task trainer with real‐time instructor feedback. After training, each physician participant will perform fLMA management in two adult patient participants under direct supervision by experienced anesthesiologists. Clinical performance will be video‐recorded and independently assessed by two blinded raters using the Flexible LMA Airway Management Global Rating Scale, for which validity evidence was established in a preceding study. Secondary outcomes include procedural success, insertion time, ventilation parameters, fLMA positioning, procedure‐related complications, learning progression, and physician participant satisfaction. Discussion This trial will evaluate whether structured distance hands‐on training improves clinical procedural performance beyond standardized video instruction. By combining randomized educational intervention, multicenter clinical assessment, blinded video‐based rating, and patient‐based outcome evaluation, the study aims to provide evidence on the transfer of distance simulation training to clinical airway management. Trial Registration: Chinese Clinical Trial Registry (ChiCTR): ChiCTR2600121867