Simulator-based videolaryngoscopy training for capacity building in intubation during COVID-19 pandemic: An institutional experience from North India

Abstract

Background: Coronavirus disease 2019 (COVID-19) pandemic has presented the healthcare sector with unique challenges. The use of a videolaryngoscope (VL) for intubation is one of the recommendations. The paucity of availability of VL outside the operation room results in lack of intubation skills with VL among clinicians. This study was undertaken to analyse the effectiveness of fast-tracked simulation-based training in enabling frontline resident doctors with skills of videolaryngoscopy. Material and Methods: Residents already trained in the skills of direct laryngoscopy underwent training on VL using the King Vision™ VL (channeled blade) through structured simulation-based training in batches of <20. Sessions included interactive lecture, demonstration by the instructor and supervised hands-on practice by residents on an airway manikin. Knowledge gained was assessed with multiple-choice questions through a pre-test and post-test. Skills gained were assessed through Objective Structured Clinical Examination (OSCE) and Direct Observation of Procedural Skills (DOPS). Feedback was taken from participants on a 3-point Likert scale. Results: 190 residents were enabled with skills of videolaryngoscopy within 3 months. Overall mean pre-test scores of 6.16 ± 1.79 improved to 7.21 ± 2.02 in post-test scores and improvement in knowledge was found to be statistically significant (P < 0.0001). Skill assessment through DOPS revealed excellent performance by 72% of participants while 3% scored borderline. OSCE results showed overall good performance by residents across various clinical disciplines. 90.4% of participants responded that training gave them the confidence to perform videolaryngoscopy. Conclusion: A well-structured simulation-based training on videolaryngoscopy is effective in imparting indirect airway management skills to residents of various clinical specialties. Simulation-based fast-tracked training is an effective method to train a large number of clinicians within a limited period.