Simulation as a set-up for technical proficiency: can a virtual warm-up improve live fibre-optic intubation?

Area of Science:

• Medical Education
• Anesthesiology
• Simulation Training

Background:

• Fibre-optic intubation (FOI) is a critical skill for anaesthesia residents, often performed under pressure.
• Virtual 'warm-up' sessions are utilized in surgical subspecialties to enhance immediate procedural performance.
• This study investigated the efficacy of a virtual warm-up for improving FOI in anaesthesia residents.

Purpose of the Study:

• To determine if a brief virtual warm-up simulation improves the performance of fibre-optic intubation (FOI) in anaesthesia residents.
• To assess the impact of simulation-based warm-up on the speed and skill of FOI.
• To evaluate the transferability of simulation training to live patient procedures.

Main Methods:

• Anaesthesia residents (CA1 and CA2) performed elective asleep oral FOI.
• Participants were randomized to either a 5-minute guided virtual warm-up using a simulator or no warm-up before live FOI.
• Performance was measured by time to intubation and a 45-point skill scale; residents later crossed over to the opposite cohort.

Main Results:

• Virtual warm-up significantly reduced intubation time by 37% for CA1 residents and 26% for CA2 residents.
• Global skill scores improved with the virtual warm-up, by 4.8 points for CA1s and 5.1 points for CA2s.
• No significant association was found between crossover period/sequence and performance outcomes.

Conclusions:

• Virtual warm-up significantly enhances anaesthesia residents' performance of fibre-optic intubation in live patients.
• The simulation-based warm-up improves both the speed and technical skill of FOI.
• This strategy offers a valuable tool for preparing residents for challenging airway management procedures.