Videolaryngoscopy Simulator: New Technology Leads to New Training Challenges

A videolaryngoscope is a more advanced tool than a traditional laryngoscope that eases endotracheal intubation by visualizing the vocal cords with a camera on the tip of the blade. However, using a videolaryngoscope can present difficulty in passing the tube into the glottic opening in some patients. This study developed a training protocol for intubation with videolaryngoscope and trained 22 anesthesia residents. A Parametrically Adjustable Airway Mannequin (PAAM) was set to provide easy and difficult configurations. Motion data of the videolaryngoscope, stylet, mannequin head, and hyoid bone were captured with 6 axis magnetic position sensors, along with the video image. The time to complete the various components of the task were recorded and used as an indication of competence along with observation by experts. The validity of the mannequin was supported by data that showed that the difficult configuration of PAAM took longer to intubate than the easy configuration (66 vs. 39 seconds during pre-test). The effectiveness of the training protocol was supported by improvement in trainee performance. At the beginning of the training, intubation with the difficult configuration took an average of 66 seconds, immediately after training it averaged 23 seconds, and in retention tests over a month after the training the average duration was 33 seconds.