Assessing Usefulness of Virtual Reality Mobile Application in Flexible Videoscope Airway Training

Study Overview
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Brief Summary
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Flexible videoscope orotracheal intubation (FOI) technique is considered an important option in the management of predicted difficult airways. However, it is rarely performed in daily practice. Yet emergency physicians are expected to be able to perform this skill expertly during a crisis scenario. If it is not completed in a timely and proper fashion, the patient will deteriorate rapidly, resulting in morbidity or fatality. There is a significant learning curve to master this complex psychomotor skill. Providing sufficient training in FOI, particularly hands-on experience in real patients is difficult. Patients with known difficult airway requiring FOI present infrequently to the emergency room. Using patients with normal airway purely for teaching of FOI is ethically controversial. To avoid technical and ethical concerns of training involving real patients, conventional teaching methods incorporate the use of a low-fidelity manikin in replacement. However, the manikin anatomy often lacks the realism of a live human. The addition of virtual reality technology, in the form of a low-cost mobile application (Airway Ex) into the conventional simulation, may optimize learning by providing an ethical, cost-effective and more realistic modality to acquire the basic skills of FOI. If it is proven to be effective, efforts to integrate virtual reality technology into routine training of such procedures in the ED should be promoted. We hypothesize that the addition of virtual reality mobile application to conventional training will improve procedural skill dexterity and proficiency and hence, improve learner's satisfaction and confidence in performing FOI.

Official Title
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Assessing Usefulness of Virtual Reality Mobile Application in Flexible Videoscope Airway Training - a Randomised Controlled Trial

Conditions
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Education, Medical

Intervention / Treatment
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* Other: Airway Ex App


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All doctors from Accidental & Emergency Department of National University Hospital, Singapore Exclusion Criteria: Refusal for consent

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Interventional<br>Additional 30 minutes of self-directed learning and practice using the mobile application, after conventional training session | Other: Airway Ex App<br>* 30 minutes of self-directed learning and practice using the mobile application<br>|
| No Intervention: Control<br>Conventional training session which includes didactic teaching and low-fidelity simulation session involving trainer's demonstration, followed by hands-on practice | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time taken for successful intubation | time from advancing scope from manikin's mouth to confirmed placement of endotracheal tube through visualisation with videoscope | 5 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time taken for visualisation of vocal cords | time from advancing scope from manikin's mouth to first visualisation of vocal cords with videoscope | 1 minute |