Virtual reality in fibre-optic intubation training: protocol for a systematic review and meta-analysis.

Abstract

Fibre-optic intubation is a crucial technique for the management of difficult airways in clinical practice, and its success rate is positively associated with the operator's experience. However, because of its low utilisation rate in clinical practice, mastery of this technique by novices often relies heavily on simulation teaching. In recent years, virtual reality (VR) technology has been introduced to simulation training of fibre-optic intubation. However, because of limited sample sizes and conflicting findings, there remains an ongoing debate regarding the widespread adoption of VR technology. The objective of this study is to evaluate the impact of VR technology on the effectiveness of fibre-optic intubation training and to provide evidence-based insights to advance VR simulation methods in this field. We will search the MEDLINE/OVID, Embase/OVID, Cochrane Central Register of Controlled Trials/OVID, CNKI and Wanfang databases from inception to March 2024. We will only include randomised controlled trials, with no restrictions on language of publication. The primary outcome will be the global rating scale score for flexible bronchoscope manipulation. The secondary outcomes will be the fibre-optic skills checklist, intubation time and proportion of successful intubations. We will assess the quality of all included trials according to the Cochrane risk-of-bias V.2 (Risk of Bias 2) tool for randomised trials. We will use the Review Manager software to perform a meta-analysis using a random-effects model and the Grading of Recommendations Assessment, Development and Evaluation approach to evaluate the quality of evidence. Ethical approval is not required for this review because we will be using only published data. We plan to submit our review to peer-reviewed academic journals. CRD42024525158.