High- versus low-fidelity simulation training for emergency front of neck access: A prospective observational study in a Swiss anesthesiology department.

Background: Emergency Front Of Neck Access techniques are an essential skill for anesthesiologists, enabling them to effectively manage the critical "can't intubate, can't oxygenate" scenarios. Current literature suggests minimal improvement in mortality associated with these scenarios due to their rarity and difficulty in providing adequate training. This study aims to evaluate whether high-fidelity training can outperform low-fidelity training in teaching Emergency Front Of Neck Access. Methods: We designed a prospective, single-blinded observational trial to assess the presumed superiority of high-fidelity training compared to low-fidelity training in teaching Emergency Front Of Neck Access to our anesthesiology department. The Performance Rating Scale (PRS) was the tool we employed to assess the participants' performance during both scenarios. The primary outcome was the difference in PRS between the high- and low-fidelity training groups. The secondary outcomes were the correlation between PRS scores and the participants' past clinical experience with Emergency Front Of Neck Access, the number of tracheostomies performed, and years of clinical service. Results: A total of 30 participants from our anesthesia department were enrolled. There was a statistically significant difference in Performance Rating Scale scores between high-fidelity and low-fidelity training. The low-fidelity group had a median score of 7 (range -7 to 9), while the high-fidelity group had a median score of -3 (range -11 to 11). None of the secondary outcomes reached statistical significance. Conclusions: Our findings suggest that the benefits of high-fidelity training may justify the additional costs associated with incorporating it into conventional airway management training.