Does Fidelity of Simulation Equipment Matter in Fiber-Optic Airway Training?

January 12, 2023

Written by Aaron Lacy

Spoon Feed
Anesthesia residents with little experience in fiber-optic intubation achieved competency faster when trained with a high-fidelity versus low-fidelity model.

Why does this matter?
Simulation is becoming more prominent, and important, in medical and continuing education. A distinct advantage of simulation is the ability to train providers on high-acuity low-occurrence (HALO) procedures, such as surgical airways. Simulation is here to stay, but the question remains – are all simulation models created equal?

Practice how you play
24 residents at a single academic center were randomly assigned to perform 20 intubations with either a high fidelity (virtual reality task trainer) or a low fidelity (wooden block trainer) fiber-optic intubation task trainer.  Residents using the high-fidelity trainer achieved competency faster than those in the low-fidelity group and overall had reduced training times (899s ± 440s vs 1358s ± 405s; 95% CI 100.46 to 818.54; p = 0.01). Four months later residents had to perform fiber-optic intubations on an ASA class I or II patient. There was no significant difference found between the two groups (p > 0) at this stage.

While this study did not show a significant clinical difference when each simulation group performed the procedure on a live patient, they were able to achieve competency faster. I would have liked to see a group that did not have any simulation training compared to the simulation groups, as I imagine there would have been a significant difference found. If your center can afford the fancy stuff, I think it is worth it, but any meaningful simulation is probably better than none.

Source
Achieving Competency in Fiber-Optic Intubation Among Resident Physicians After Higher- Versus Lower-Fidelity Task Training: A Randomized Controlled Study. Anesth Analg. 2022 Nov 29. doi: 10.1213/ANE.0000000000006283. Online ahead of print.