Background and aims Effectiveness of mannequin based simulation (MBS) has been well established in the management of a life threatening critical incidents like local anesthetic systemic toxicity (LAST) but its application can be limited by cost and availability. Another possible solution is the use of a virtual reality simulator (VRS).
Methods 20 anesthesia trainees were randomized to receive identically scripted LAST simulation training in session 1 by either VRS or MBS followed by the same debriefing procedure. the trainee was assisted by a simulated nurse assistant and 2 other medical assistants to provide CPR, drug administration and other tasks either by VR avatars or live simulation staff. Two weeks after the initial simulation session, trainees were retested in session 2 using a standardized MBS (SimMan); for the same LAST scenario. All stimulation sessions were videotaped and were reviewed by two investigators independently, trainees were rated on non-technical skill (ANTS) performance based on a previously validated checklist (table 1).
Results Individual checklist and ANTS scores for VRS and MBS groups are shown in figure 1. For the VRS group, there was significant improvement in ANTS performance from session 1 to 2 but no significant difference in performance based on checklist assessment (table 2). For the MBS group, significant improvement was found in both ANTS and checklist performance (table 2).
Conclusions The VRS prototype proved to be useful in management of LAST, however, the mechanisms by which MBS and VRS improve retention of knowledge and skills need to be better understood by conducting larger scale studies.
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