Is there a benefit for anesthesiologists of adding difficult airway scenarios for learning fiberoptic intubation skills using virtual reality training? A randomized controlled study

Introduction: Fiberoptic intubation for a difficult airway requires significant experience. Traditionally only normal airways were available for high fidelity bronchoscopy simulators. It is not clear if training on difficult airways offers an advantage over training on normal airways. This study investigates the added value of difficult airway scenarios during virtual reality fiberoptic intubation training.
Methods: A prospective multicentric randomized study was conducted 2019 to 2020, among 86 inexperienced anesthesia residents, fellows and staff. Two groups were compared: Group N (control, n=43) first trained on a normal airway and Group D (n=43) first trained on a normal, followed by three difficult airways. All were then tested by comparing their Global Rating Scores (GRS) on 5 scenarios (1 normal and 4 difficult airways).
Results: The final evaluation GRS score for the normal airway testing scenario was significantly higher for group N than group D: median score 76% (IQR 56.5 - 90...