Two hours of supervised virtual reality training and fibreoptic bronchoscopy performance in novice learners: a randomised pilot study

Fibreoptic tracheal intubation remains an important airway-management skill, but clinical training opportunities are limited. Virtual reality simulation may facilitate skill acquisition before patient contact.

To compare simulator-generated ORSIM® composite scores and consultant-assessed Global Rating Scale scores after two hours of supervised ORSIM® training versus 10-min familiarisation in novice learners, and to explore associations between baseline dexterity, participant characteristics and simulator performance.

In this prospective randomised pilot study, 20 medical students without previous fibreoptic bronchoscopy experience were allocated to 10-min familiarisation or two hours of supervised ORSIM® practice. Baseline dexterity was assessed before allocation was revealed. Participants completed four airway scenarios. ORSIM® composite scores and Global Rating Scale scores assessed by a consultant masked to assignment were the prespecified primary outcomes. Analyses were descriptive.

Ten participants were allocated to each group and all completed the study. The two-hour group had higher mean ORSIM® composite scores across all four scenarios, with the largest difference in macroglossia (68.1% versus 45.5%). Global Rating Scale scores were similar for oral bronchoscopy and modestly higher in the two-hour group for the remaining scenarios. Higher baseline dexterity and video gaming experience appeared associated with better simulator performance; these subgroup comparisons were exploratory.

In this small pilot sample, two hours of supervised ORSIM® practice was associated with higher ORSIM® composite scores than 10-min familiarisation, particularly in the macroglossia scenario. These descriptive findings do not establish clinical proficiency or transfer to patient care. Larger studies should assess retention and clinical transfer.