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October 20, 2008
2:00 PM - 4:00 PM
Room Hall E2-Area J,
Virtual Multimedia Tool Improves the Acquisition of Fiberoptic Intubation Skills by Medical Students
Sylvain Boet, M.D., Simon Fischhof, M.D., Nathalie Stojeba, M.D., Roland Schaeffer, M.D., Pierre Diemunsch, M.D., Ph.D.
Anesthesiology and Intensive Care, Univeristy Hospital of Strasbourg, Strasbourg, France
Introduction and background:

The use of a fiberoptic scope is the gold standard in managing predicted difficult intubation in anesthesia. Nevertheless, this technique still represents a challenge to many anesthesiologists, probably due to the difficulty in acquiring this skill.

The goal of this study is to evaluate if the use of the multimedia tool “Virtual Fiberoptic Intubation” CD-rom (VFI)1 will facilitate the learning of fiberoptic intubation of the trachea, by comparison with the classical way of teaching.

Materials and Methods:

After informed consent, medical students were randomised into two groups. The “usual didactic group” (UD) was taught by the usual institutional didactic method only, including description of the technique, review of the anatomy of the upper airways and technical advice from an expert bronchoscopist. The “VFI group” had, in addition to that, a formal introduction to the VFI software and had to self-practise on a computer until being able to perform a virtual fiberscopy easily.

Each student was evaluated on its first orotracheal fiberoptic intubation of the head manikin (Laerdal® Airway Management Trainer), with the fiberoptic scopes (Karl Storz®) equipped with a camera and a LCD screen .

Success/failure criterion was the main endpoint, evaluated by a staff anesthesiologist blinded to the type of previous teaching. Student's satisfaction was the secondary endpoint.


Forty two medical students were enrolled, 21 in each group.[table1]In the VFI group, 17 out of 21 students have succeed in intubation of the mannequin, and only 11 out of 21 in the didactic group.

The difference in success rate between the VFI and UD groups is significant (p<0.05, Pearson Chi-square test).

Among the 14 failures, 10 are due to oesophageal intubation (9 in UD group, 1 in VFI group), and 4 due to the performance time > 4 minutes (1 in UD group, 3 in VFI group).

All the students in the VFI group have expressed excellent satisfaction with the program.


For medical students, self-training in fiberoptic intubation with the VFI software has improved the acquisition of fiberoptic intubation skills and was very well accepted.


1 APSF Newsletter 2003-2004;18 (4):48.

Anesthesiology 2008; 109 A1181
Success rate of medical students beetween the 2 groups.
VFI group17421
UD group111021