Selection of participants
All fifth-year medical students at the centre were eligible for this study. All provided written informed consent to participate and signed confidentiality agreements to prevent the study protocol from being leaked to other students. Students who had previously learned or performed cricothyrotomy, declined consent, or violated the study protocol were excluded. The participating students were not informed about the study aims or outcomes of interest. All data were collected and anonymised.Fifth-year medical students were divided by the Faculty of Medicine into small teams of two or three members. We used these teams as units and randomly (using computer-generated numbers) assigned them to learn either the top-down manoeuvre (odd numbers) or the bottom-up manoeuvre (even numbers) first, in a ratio of 1:1. This randomisation of the order of instruction and procedures attempted to minimise the impact of learning effects. The study was conducted at the beginning of the one-week ED rotation.