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Is a haptic simulation interface more effective than computer mouse-based interface for neonatal intubation skills training?
  1. Anup Agarwal1,
  2. Julie Leviter2,
  3. Candace Mannarino2,
  4. Orly Levit2,
  5. Lindsay Johnston2,
  6. Marc Auerbach2
  1. 1Department of Internal Medicine, New York Medical College, Valhalla, New York, USA
  2. 2Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA
  1. Correspondence to Dr Anup Agarwal, Department of Internal Medicine, New York Medical College, Westchester Medical Center, Valhalla, NY 10595, USA; mailanupagarwal{at}


Objective To compare the efficacy of a three-dimensional (3D) haptic interface to a two-dimensional (2D) mouse interface for a screen-based simulation (SBS) neonatal intubation (NI) training intervention. Primary hypothesis: a haptic interface is more effective than a mouse interface for SBS training intervention for NI. Secondary hypothesis: SBS training, regardless of interface, will result in improved NI performance on a neonatal airway simulator.

Methods 45 participants were randomised to either a haptics or a mouse interface to complete an identical SBS training intervention for NI over a five-month period. Participants completed pre- and post-training surveys to assess demographics, experience, knowledge and attitudes. The primary outcome of participants’ NI skills performance was assessed on a neonatal manikin simulator. Skills were measured pre- and post- training by number of attempts and time to successfully intubate, and airway visualization.

Results The demographics, training and experience were similar between groups. There was no difference in the improvement in skills, knowledge, attitudes or satisfaction ratings pre- and post-training between the groups. There was a significant decrease in number of attempts to intubate a neonatal airway simulator (2.89 vs 1.96, p<0.05) and improvement in the percent of subjects intubating in <30 seconds (22% vs 27%, p=0.02) from pre- to post-training in the study population overall.

Conclusion Using a haptic interface did not have an advantage over a mouse interface in improving NI skills, knowledge, attitudes, or satisfaction. Overall, a SBS training intervention for NI improved skills measured on a neonatal airway simulator.

  • computer simulation
  • intubation
  • infant, newborn
  • user-computer interface

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