title: Airway management in a bronchoscopic simulator based setting: an observational study.
abstract: BACKGROUND
  Several simulation-based possibilities for training flexible optical intubation have been developed, ranging from non-anatomical phantoms to high-fidelity virtual reality simulators. These teaching devices might also be used to assess the competence of trainees before allowing them to practice on patients.
  
  
  OBJECTIVE
  To evaluate the validity of airway simulation as an assessment tool for the acquisition of the preclinical basic skills in flexible optical intubation and to investigate anaesthetists' opinion on airway simulation.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  International airway course.
  
  
  METHODS
  Thirty-six consultants and residents in anaesthesiology.
  
  
  METHODS
  All participants performed one single procedure on each of the three different simulators. Their video-filmed performances were assessed by two independent, blinded experts and their opinions of simulation were surveyed.
  
  
  RESULTS
  The mean score increased 0.33 points after each attempt (P = 0.021). The attitude towards simulation-based training was always more than 4 on a scale from 1 to 5. Only 25% of the procedures were performed to satisfaction with a learning-by-testing effect (P = 0.021). Generalisability coefficient was 0.55, and there was no correlation between the number of clinical procedures performed beforehand and test scores (P = 0.93).
  
  
  CONCLUSIONS
  The increase in mean score is a learning effect indicating that simulator training allows for entry of the learning curve at a higher level. The anaesthetists in our study agreed completely that simulation-based training was useful regardless of the fidelity of the simulator. Local, practical issues such as cost and portability should decide available simulation modalities in each teaching hospital.
authors.affiliation: From the Copenhagen University Hospital Rigshospitalet (KG, MSK, AGU, KH) and University of Copenhagen and the Capital Region of Denmark, Centre for Clinical Education, Copenhagen, Denmark (LK, CR).
authors.forename: Karin
authors.initials: K
authors.lastname: Graeser
authors.forename: Lars
authors.initials: L
authors.lastname: Konge
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kristensen
authors.forename: Annette G
authors.initials: AG
authors.lastname: Ulrich
authors.forename: Kaare
authors.initials: K
authors.lastname: Hornbech
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ringsted
mesh_terms: D000328:Adult; D058109:Airway Management / Q000379:methods*; D000776:Anesthesiology / Q000193:education; D001999:Bronchoscopy / Q000193:education*; D002983:Clinical Competence; D003198:Computer Simulation; D006801:Humans; D007396:Internship and Residency; D007442:Intubation, Intratracheal / Q000379:methods*; D008875:Middle Aged; D014584:User-Computer Interface