Cadaver-Based Procedural Skills Lab Improves Confidence in High-Risk ICU Procedures Among APPs

Introduction: Advanced practice providers (APPs) are increasingly tasked with performing high-risk ICU procedures. However, many APPs report limited procedural exposure during onboarding and postgraduate education. Simulation-based curricula often lack the anatomical fidelity needed for these invasive procedures. Cadaver-based training may bridge this gap, yet its impact on APPs remains underexplored.

We hypothesized that participation in a cadaver-based procedural skills lab would improve APPs’ confidence in performing high-risk ICU procedures, particularly among those without prior experience.


Methods: We developed and implemented a cadaver-based procedural skills lab at a national critical care conference for APPs. Participants completed pre- and post-course surveys capturing demographics, prior experience, and self-reported confidence (scale 1–10) in performing intubation, cricothyrotomy, IO placement, and finger thoracostomy. Change in confidence scores were analyzed descriptively.


Results: Of 31 participants, 27(87%) completed both pre- and post- course surveys. Following the cadaver-based lab, mean confidence scores increased across all assessed procedures. Of those who completed the survey 20 (74%) described themselves as inexperienced, with 7(26%) describing themselves as experienced. Inexperienced participants demonstrated the largest gains with mean confidence scores for intubation increasing from 3.2 to 7.6, while the experienced participants increased from 5.6 to 8.1. For finger thoracostomy, confidence scores rose from 2.8 to 7.5 for the inexperienced group and from 3.9 to 7.8 in the experienced group. Across all procedures, confidence scores narrowed between experienced and inexperienced APPs following the course.


Conclusions: A cadaver-based procedural skills lab improved APP confidence in high-risk ICU procedures, with the largest gains observed in novice participants. These findings support cadaver-based training as a valuable supplement to APP onboarding and procedural competency development. Future research should explore the relationship between procedural confidence and procedural success.