Simulated Success: Improving Patient Comfort and Skill in Laryngoscopy Training

Introduction: Flexible laryngoscopy is essential for otolaryngologists in assessing the upper airway, but traditional training methods, such as the 'see one, do one, teach one' approach, can lead to patient discomfort and anxiety. Simulation-based training has shown promise in boosting resident confidence and alleviating patient discomfort. This study explores the use of a high-fidelity simulation mannequin to improve resident performance and enhance patient comfort during laryngoscopy training.

Methods: Fourteen otolaryngology residents were randomized into two groups (n=7 each). Both groups initially performed flexible laryngoscopy on 10 patients who completed baseline and post-procedure pain surveys. The intervention group practiced 10 sessions on a high-fidelity mannequin, while the control group watched a didactic video. Both groups then performed laryngoscopy on 10 additional patients who also completed baseline and post-procedure pain surveys. All procedures were reviewed by a laryngologist to assess anatomy identification, laryngoscope control, and time to vocal fold visualization.

Results: Both groups showed improvement in laryngoscopy overall performance, but the simulation group outperformed the control group in anatomy identification score and time to vocal fold visualization (p < 0.05). The simulation group’s time to vocal fold visualization decreased by 41%, compared to 14% in the control group. The experimental group showed a slightly greater average pain reduction compared to the control group, but this difference was not statistically significant (p=0.847). All 7 participants in the experimental group evaluated the simulator on its realism, with an average score of 4.3 out of 5.

Conclusions: High-fidelity simulation training significantly improved laryngoscopy performance, highlighting its value in enhancing resident proficiency and confidence. While pain reduction was slightly greater in the simulation group, this difference was not statistically significant, highlighting the need for further investigation into patient comfort outcomes.