Virtual airway simulation to improve dexterity among novices performing fibreoptic intubation

Abstract

Summary We developed a virtual reality software application (iLarynx) using built‐in accelerometer properties of the iPhone® or iPad® (Apple Inc., Cupertino, CA, USA) that mimics hand movements for the performance of fibreoptic skills. Twenty novice medical students were randomly assigned to virtual airway training with the iLarynx software or no additional training. Eight out of the 10 subjects in the standard training group had at least one failed (> 120 s) attempt compared with two out of the 10 participants in the iLarynx group (p = 0.01). There were a total of 24 failed attempts in the standard training group and four in the iLarynx group (p < 0.005). Cusum analysis demonstrated continued group improvement in the iLarynx, but not in the standard training group. Virtual airway simulation using freely available software on a smartphone/tablet device improves dexterity among novices performing upper airway endoscopy.

The Impact of Electronic Reading Devices on Reading Speed and Comfort in Patients with Decreased Vision

“…As portable electronic devices become more versatile, both medical professionals and patients will continue to adopt them in a variety of healthcare scenarios [13–16]. Electronic reading devices are particularly promising since they may easily magnify text and enhance contrast without cumbersome equipment or significant effort from the user.…”

Practical aspects and training in fibreoptic intubation

“…However, attendance rates for workshops are variable, ranging from 31% in the UK to 65% in Canada [83,96]. High fidelity laboratory and portable simulation teaching aids have been developed, including software on smartphones and electronic tablets that mimic hand movement for the performance of FOI skills [97,98]. The latter was developed by De Oliveira et al who showed that novice medical students who received additional virtual reality simulation training performed better than those without [97,98].…”

“…High fidelity laboratory and portable simulation teaching aids have been developed, including software on smartphones and electronic tablets that mimic hand movement for the performance of FOI skills [97,98]. The latter was developed by De Oliveira et al who showed that novice medical students who received additional virtual reality simulation training performed better than those without [97,98]. The use of low fidelity ('choose-a-hole' in a wooden box) models has been shown to be as effective as high fidelity simulators (mock videolaryngoscopy with realistic renderings of airway anatomy and haptic feedback) in transferring simulation FOI skills into clinical practice [99].…”

Evidence base in airway management training

“…Different alternative methods to clinical training have been described: cadaver practice for teaching cricothyroidotomy, 27 partial task trainers for simulated practice of various techniques (direct laryngoscopy, 28 extraglottic airway device (EAD) insertion, 29,30 videolaryngoscopes, fiberoptic intubation, cricothyroidotomy 31,32 ), computer-based or smart phone applications for teaching fiberoptic intubation, 33,34 videolaryngoscopes to demonstrate and teach ETI in simulated or real life settings, 35 full scale manikin simulation, 36e38 to name the most frequently used methods.…”

“…33 When comparing anaesthesia residents with iLarynx ® training to those who had only standard training there was fever failure in the intervention group. The use of the software appears to improve trainees' dexterity.…”