Nasal Fiber-optic Intubation Training for Nurse Anesthesia Students Incorporating Deliberate Practice and Summative Assessment.

Abstract

Introduction: Managing difficult airways and adverse respiratory events is critical for anesthesia providers. Fiber-optic intubation (FOI) is a strategic management approach in difficult airway situations. Clinical exposure to FOI can be limited, posing challenges for skill development. Simulation-based medical education offers a safe alternative for training. This study aims to evaluate the effectiveness of a simulation-based FOI training program for student registered nurse anesthetists (SRNAs) in an educational context.

Methods: A repeated measure study was conducted during the Pediatric Anesthesia Simulation for Student Nurse Anesthetists course at the Peter M. Winter Institute for Simulation, Education, and Research. One hundred twenty-three SRNAs participated in the FOI simulation program. For the analysis, students were stratified into 2 groups based on their performance in the summative testing of nasal FOI time. Baseline characteristics and the students' performance during the simulation were analyzed.

Results: Among the participants, 58 were categorized as "above median time" (AMT) and 65 as "below median time" (BMT) for FOI testing. No significant differences were observed in baseline characteristics. The AMT group exhibited longer mean times for summative testing FOI (50 vs. 26 seconds), first FOI attempt (97 vs. 78 seconds), and subsequent sets (third: 374 vs. 325 seconds, fourth: 323 vs. 268 seconds). Both groups showed performance improvement across training sets with reduced variability.

Conclusions: The simulation-based FOI training program effectively enhanced SRNA skill, with performance improvement during the training period. This study underscores the importance of simulation in anesthesia education, offering a safe and structured environment for skill development in FOI.