DR. MANOJ ADITYA B,DR. MRUNALINI M N,DR. S. BHUMINATHAN
DOI: https://doi.org/Background:
Fiberoptic bronchoscopy (FOB) is a critical skill for managing difficult airways, especially during awake intubations and emergency scenarios. Traditional clinical training poses risks to patients and limits opportunities for repeated practice. Simulation-based training offers a safe, controlled environment to develop scope navigation skills, reduce patient harm, and improve procedural efficiency.
Objectives:
To evaluate the impact of simulation-based FOB training on first-pass intubation success rates, airway management efficiency, safety outcomes, and practitioner confidence among anesthesiologists.
Methods:
This prospective, randomized controlled trial recruited anesthesiology trainees and early-career anesthesiologists. Participants were randomized into:
- Simulation Group: Received structured high-fidelity FOB simulator training with guided practice in airway navigation and intubation scenarios.
- Control Group: Received standard FOB education, including lectures, video demonstrations, reading materials, and supervised clinical practice without simulation.
Primary Outcome: First-pass success rate during clinical FOB intubations.
Secondary Outcomes: Time to secure the airway, number of intubation attempts, incidence of mucosal trauma, and subjective confidence scores.
Data were analyzed using chi-square tests for categorical variables and t-tests/ANOVA for continuous variables.
Results:
Simulation-based training significantly improved first-pass success rate (93% vs. 60%, p < 0.05) and reduced mean intubation time (70s vs. 112s). The average number of attempts decreased from 2.2 to 1.1, and mucosal trauma incidence dropped from 27% to 7%. Confidence scores increased from 4.9 to 8.5.
Conclusion:
Simulation-based FOB training markedly enhances clinical performance, efficiency, safety, and practitioner confidence in fiberoptic intubations. Incorporating simulation into anesthesiology training programs can improve patient outcomes and operator preparedness.
