Virtual reality simulation for critical pediatric airway management training

BACKGROUND: Pediatric airway emergencies are relatively rare, but have potentially devastating consequences. Simulation based education is important in providing zero-risk management experience for these critical events. AIMS: The aim of the study was to assess usability and feasibility of combined interactive instructional videos and a novel Virtual Reality (VR) trainer for healthcare professionals and to evaluate the impact of this combination on learners’ knowledge of critical airway events in children. METHODS: The study population included medical students, residents, faculty, and advanced practice nurses. Participants completed a short baseline knowledge pre-test of pediatric airway emergency management, followed by these consecutive interventions: (1) Interactive instructional pediatric airway videos and (2) VR trainer (HoloLens technology), simulating a pediatric critical airway event. Participants were randomized to manage anaphylaxis or foreign body aspiration. Finally, participants completed a second knowledge test (post-test) and a survey of their perceptions of the videos and VR trainer. RESULTS: Forty-one participants were included in the study. Overall, both interventions were well received. Positive perceptions included realism, interactivity, and active learning environment. Negative comments focused on video speed and the VR trainer learning curve. Participants reported preferences for future training of pediatric airway events to include videos and VR trainers, with or without didactic lectures. Most areas of knowledge showed slight to significant improvements following the interventions. Specifically, questions on pediatric anatomy, anaphylaxis, Heimlich maneuver, and foreign body removal showed the highest improvement in scores (P < 0.05). CONCLUSIONS: Interactive videos, in combination with a VR experience, provide promising zero-risk training for pediatric critical airway events. RELEVANCE FOR PATIENTS: Pediatric airway emergencies are relatively rare, but the potential consequences are devastating. VR is established as a valued mode of education with regard to medical emergency training. Multimedia informational and instructional formats result in greater understanding of information. Results from our intervention, combining an interactive video tutorial and a VR experience, show this was well received by a cross section of health-care providers. We demonstrated improved test scores in a pediatric airways quiz.