Use of Alexa as a Cognitive Aid for Emergency Front Of Neck Access (FONA)

Study Overview
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Brief Summary
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The aim of the study is to investigate whether a voice activated cognitive aid can improve performance in a simulated emergency front-of-neck access scenario. This skill is ideally practiced on an annual basis by anaesthetists in training, with a variety of usually low-fidelity simulation used. The addition of the Alexa cognitive aid is a novel step with the aim of improving adherence to the recommended steps required to successfully complete the procedure. One arm of this study will be introduced to the Alexa checklist in advance of performing the procedure prior to crossover, whereas the second arm will not (subject to standard anaesthetic training).

Official Title
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The Role of a Visual Alexa Enabled Visual Device in Aiding Performance in Emergency Front-of-Neck Access (eFONA-A) Within a Simulated 'Can't Intubate Can't Oxygenate' Scenario

Conditions
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Intubation; Difficult or Failed

Intervention / Treatment
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* Device: Use of Alexa Visual Cognitive aid


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: CT1 to Consultant level Anaesthetists, who have completed the Initial Assessment of Competencies (IAC) Exclusion Criteria: Anaesthetists without the above criteria, refusal

Ages Eligible for Study
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Minimum Age: 23 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: Randomisation will be carried out using a randomization table made at www.randomizer.org to even/odd allocation numbers corresponding to 'Alexa first' vs 'No Alexa first' group with equal allocation between each arm. The randomisation sequence will be known only to the investigators issuing the initial grouping to the candidate, and allocations will be concealed from the video recording assessors and the statistical analysis team.
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: eFONA No Alexa<br>Arm randomised to performing the procedure without Alexa cognitive aid first | Device: Use of Alexa Visual Cognitive aid<br>* The intervention is the use of of a cognitive aid to determine the efficacy of the aid in completing the steps correctly.<br>|
| Experimental: eFONA Alexa<br>Arm randomised to performing the procedure using Alexa cognitive aid first | Device: Use of Alexa Visual Cognitive aid<br>* The intervention is the use of of a cognitive aid to determine the efficacy of the aid in completing the steps correctly.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The number of critical steps missed. | What critical steps were missed | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| All critical steps completed | What critical steps were completed | 6 months | 
| Hypoxic time (interval between SpO2 first <94% to recover >=94% - explicitly timed gradual decrease in saturations) | What was the hypoxic time | 6 months | 
| A measure of participant workload (e.g. NASA-TLX) as perceived and completed by the participant after each arm. | Workload time versus perceived time per participant | 6 months | 
| A measure of team working (e.g. ANTS score) for each individual procedure | Actual measure per participant per procedure | 6 months | 
| A measure of participant's subjective experience (e.g. qualitative analysis of participant feedback on the device) | Feedback from each participant about the device | 6 months |