Low-cost versus high-fidelity pediatric simulators for difficult airway management training: a randomized study in continuing medical education

Background: High-fidelity (HF) pediatric patient simulators are expensive. This randomized study aimed to compare the quality and educational impact of a full-scale simulation workshop with an HF infant simulator (SimBabyTM, Laerdal) or with a low-cost (LC) simulator composed of an inert infant manikin with SimBabyTM software that displays respiratory/hemodynamic parameters on a monitor for medical education in pediatric difficult airway management. Methods: After written informed consent, anesthetists and emergency or ICU physicians participated in teams (4 to 6 participants) in a training session that included direct participation and observation of two difficult intubation scenarios. They were randomized into two groups (HF group, n = 65 and LC group, n = 63). They filled out a simulation quality score (SQS, 0 to 50), self-evaluated their anesthetists' non-technical skills (ANTS) score (15 to 60), and an educational quality score (EQS, 0 to 60) immediately (T0, main criteria), as well as 3 (T3) and 6 (T6) months after the training session. Results: We enrolled 128 physicians. Direct participation SQS (39 & PLUSMN; 5 HF group versus 38 & PLUSMN; 5 LC group), observation SQS (41 & PLUSMN; 4 H F group versus 39 & PLUSMN; 5 LC group), ANTS scores (38 & PLUSMN; 4 HF group versus 39 & PLUSMN; 6 LC group), T0 SQS (44 & PLUSMN; 5 HF group versus 43 & PLUSMN; 6 LC group), T3 and T6 SQS were not different between groups. Conclusion: Our low-cost simulator should be suggested as a less expensive alternative to an HF simulator for continuing medical education in pediatric difficult airway management. & COPY; 2021 Published by Elsevier Editora Ltda. on behalf of Sociedade Brasileira de Anestesiologia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).