Development and validation of a sensorized neonatal intubation skill trainer for simulation based education enhancement

Abstract

Introduction: Oro-tracheal intubation requires a great deal of clinical experience to avoid serious complications. The level of attention needed is even greater in the neonatal field due to newborns' unique anatomical features. Therefore, specific skill trainers become fundamental in training programs for residents and expert clinicians. However, the current commercial devices are totally passive and, as a result, the operator receives no feedback on the accuracy of the procedure. Materials and Methods: An active sensorized skill trainer for neonatal intubation was designed and assembled by fixing force sensors on a commercial infant simulator. A dedicated user-friendly interface was developed which provided both visual (red or green light) and audio (alarm or winning sound) realtime feedback during intubation. The active neonatal skill trainer was included in a comparative analysis with passive traditional systems, and involved 10 residents in Anesthesiology without previous experience in neonatal intubation. Data on execution times and alarm conditions were gathered. Results: Based on experimental results, the best trainees' performances were obtained with the active skill trainer after a previous training session with a passive intubation mannequin. In addition, by evaluating the number of sensors-laryngoscope contacts, the superior gingival arch and neck emerged as critical anatomical landmarks contacted during any intubation procedure. Conclusions: The active simulator can be considered an innovative instrument for neonatal intubation training. The proposed device potentially represents a valid learning instrument which can shorten the intubation task learning curve.