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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2012 Aprile;78(4):456-61
Self-directed deliberate practice with virtual fiberoptic intubation improves initial skills for anesthesia residents
Giglioli S. 1, Boet S. 2, De Gaudio A. R. 1, Linden M. 1, Schaeffer R. 3, Bould M. D. 4, Diemunsch P. 3 ✉
1 Department of Anesthesia and Critical Care, University of Florence Azienda Ospedaliero - Universitaria di Careggi, Florence, Italy;
2 Department of Anesthesia, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada;
3 Department of Anesthesia and Critical Care, Hôpital de Hautepierre; University of Strasbourg, Strasbourg, France;
4 Department of Anesthesia, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
BACKGROUND: Fiberoptic intubation is a core skill in anesthesiology. However, this complex psychomotor skill is challenging to learn in the clinical setting. The goal of this study was to evaluate the Virtual Fiberoptic Intubation (VFI) software as an adjunct to the traditional fibreoptic intubation teaching.
METHODS: After informed consent, 23 first year anesthesia residents with no previous experience of fiberoptic intubation were randomized to 2 groups. All subjects received an institutional didactic teaching session. The control group (N.=12) was taught by the usual didactic method only, while the VFI group (N.=11) had the same didactic teaching and also the opportunity to practice with VFI software for one week. Each resident was evaluated on their first oro- and nasotracheal fiberoptic intubations on a mannequin head. Each performance was evaluated by an expert bronchoscopist blinded to the previous type of teaching using a checklist score, a global rating scale (GRS) score and procedural time.
RESULTS:The VFI group performed significantly better on the checklist and GRS scores compared to the control group for both the oral and nasal routes (all P<0.05). For procedural time, there was a trend towards faster performance in the VFI group compared to the control group for the oral route (P=0.05). There was no significant difference for procedural time between the VFI and the control groups when fiberoptic intubation was performed nasally (P=0.76).
CONCLUSION: Self-directed practice using VFI software may improve the initial acquisition of fibreoptic intubation skills for anesthesia residents.