Enhancing Emergency Airway Management Training with Virtual Reality

Background:

Emergency airway management is a critical skill for anaesthetists, particularly in scenarios where a patient cannot be intubated or oxygenated (CICO). Traditional training methods, while effective, can be resource-intensive, requiring high-fidelity simulation equipment and physical presence. To address these challenges, the Thames Valley School of Anaesthesia collaborated with Goggleminds® to develop an immersive virtual reality (VR) simulation based on the 2015 Difficult Airway Society guidelines. This simulation aims to improve trainee preparedness for emergency front of neck access (eFONA), a key intervention in the CICO scenario.

The Solution:

The novel VR simulation was designed to immerse trainees in a fully interactive CICO scenario, allowing them to practise life-saving techniques in a controlled virtual environment. The training involved:

• A Plan D CICO scenario delivered via head-mounted displays.
• Supplementary micro-skills stations focusing on key procedures like patient positioning and chest X-ray review.
• Integration with standard CICO training to reinforce the learning experience.

The project was reviewed by the Joint Research Office of Oxford University, which classified it as an evaluation of educational provision.

Data and Impact:

A cohort of 17 first-year core anaesthetic trainees participated in the VR simulation following their standard CICO training. The results demonstrated significant improvements in performance and confidence:

• Skill Improvement: Post-training, participants scored 5.7 points higher on average in identifying key steps for eFONA (p = 0.004).
• Confidence and Learning: Self-reported confidence and perceived learning improved significantly, with a mean score of 4.53/5 for both.
• Qualitative Feedback: Participants praised the interactive, repetitive nature of the VR training, with comments such as:
  • "Experience was brilliant."
  • "Repetition cemented learning."
  • "Great opportunity to practise key skills."

Key Figure 1:

• Stat: 5.7 Points Improvement in eFONA Step Identification.
• Post-training scores increased by 5.7 points, indicating a significant improvement in knowledge of emergency front of neck access steps.

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Key Figure 2:

• Stat: 4.53/5 Confidence and Learning Rating.
• Trainees reported a high level of confidence and perceived learning after the VR session.

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Conclusion:

The VR-based CICO simulation represents a valuable adjunct to traditional teaching methods, providing a safe, realistic, and accessible platform for training critical emergency airway management skills. Trainees reported enhanced learning experiences, increased confidence, and appreciated the ability to practise in a simulated environment. This VR approach holds promise for improving the frequency and accessibility of training while reducing equipment and environmental costs in anaesthesia education.

Future research will focus on long-term skill retention, multidisciplinary training, and the preparatory value of VR before high-fidelity simulation sessions.