DESCRIPTION (provided by applicant): Pediatric and neonatal airway management skills are life-saving, difficult to master, and used infrequently enough to make skill maintenance a serious challenge. For example, multiple studies have shown that pediatric and neonatal intubation procedures are often successful less than half of the time, especially among residents. Given the long skill acquisition cycles (in spite of modern simulation training), new training methodologies are required. In recent years, there has widespread adoption of patient simulators in the medical education community. The didactic value of these simulators could be significantly improved if the trainee was able to understand the location of internal landmarks, as well as visualize normal and pathological states of the body during training. This would help trainees understand the relationship between their actions and what is occurring in the body. ArchieMD proposes to develop a pediatric airway mixed reality medical simulation system to combine multimedia technologies with manikins to enable internal anatomy overlays on medical trainers. Using mixed reality tracking, ArchieMD's 3D imagery of the body's internal anatomy can be superimposed over the view of the user, providing additional 3D didactic information while using a task trainer manikin. The resulting overlayed video stream is then displayed on a widescreen monitor. This provides highly effective synergy between the visual and hands-on component of medical education. Optical sensors allow integration of the medical equipment with the anatomy models and the manikin while the procedures are being conducted. This results in a realistic anatomic and physiologic representation of the patient. Pilot data was collected from 21 medical students using our Phase I prototype. There were statistically significant improvements in cognitive and skills assessments from baseline to post- intervention. For the cognitive assessment, the mean scores improved from 56.5 percent to 82.0 percent (p= <0.001). For the skills assessment, the mean scores improved from 70.4 percent to 94.2 percent (p= <0.001) revealing a big impact from this one-time, relatively brief intervention. During Phase II, we will expand the pediatric airway mixed-reality trainer to cover a full range of prenatal and neonatal difficult airway scenarios and incorporate a full range of prenatal and neonatal appropriate supraglottic/extraglottic airway devices. The system's didiactic value will be evaluated in a randomized controlled trial to assess the ability of the Mixed Reality Medical Student Trainer Platform to improve procedure skills, as compared to traditional manikins.

PUBLIC HEALTH RELEVANCE: The mixed-reality trainer for pediatric airway procedures to be developed under this project will improve the success rates of medical students, residents, fellows and physicians. This will in turn help reduce complications caused by unsuccessful intubations in neonatal and pediatric patients, up to and including death.