Fibre optic intubation training with the help of smartphone application 

Background and the goal of the study
The younger generation of the anesthesiologist is familiar with both video games and benefits of interactive technology. They could develop their skills by the help of the virtual reality software application (app) iLarynx which mimics hand movements for the performance of fibre optic intubation (FOI). The goal of our study is to investigate whether the FOI learning process is more efficient when the app is being used.

Materials and methods 
Randomised, controlled, single-blinded trial was held in the Lithuanian University of Health Sciences. Medical students (n=54) have been taught about the FOI in the theoretical lecture, after which they were randomly divided into two groups: G1 – iLarynx training (n=28), G2 – no additional training (n=26). G1 was instructed to use the iLarynx app for the whole month until they will be satisfied with their FOI performance. After the month, students’ skills were being tested with the help of the FOI moulages. The duration of the task fulfillment was assessed. Researchers who observed FOI were unaware of students’ group allocation. Results are presented as mean ± standard deviation or median. Differences between independent samples were measured by nonparametric tests at p<0.05.

Results and discussion
There was no significant difference in the duration of intubation between the groups (G1 56.46±17.825 s, G2 58.04±29.26 s, U=336,5, p=0.634). 27 students (50.0%, n=54) who had previous experience with endotracheal intubation were equally divided between the groups (G1 – 13 stud., G2 – 14 stud., χ²=0.586, p=0.768). G1 used the iLarynx app from 1 to 10 times a week, the median is 3 times a week. Weekly duration of training was 4 – 60 min, average 17.43±16.43 min. G1 students used the app significantly more often if they have had previous endotracheal intubation experience. (U=54.5, p=0,04). Results might be so due to modest sample and learning period. Further work is necessary. 

Conclusion:
 The data shows no significant change in the fibre optic intubation learning efficiency. The motivation to practice is bigger when a student already has experience in the particular field. 

References:
De Oliveira GS Jr et all. Virtual airway simulation to improve dexterity among novices performing fibreoptic intubation. Anaesthesia. 2013 Oct;68(10):1053-8.