January 22, 2021

Can extended reality help teach the difficult airway algorithm?

Michigan Anesthesiology receives Center for Academic Innovation grant to produce 360-degree video for learners.

Virtual reality headset

When confronted with an unanticipated difficult airway, seasoned anesthesiologists draw on their previous experiences and put into motion the algorithm they’ve committed to memory. For anesthesia trainees, getting comfortable with unanticipated scenarios takes a bit of memorization — and a lot of practice.    

Learners in the Department of Anesthesiology have long relied on hands-on learning through the Clinical Simulation Center to gain confidence in high-risk situations. They’ll soon have another way to gain exposure to critical events as a team of faculty and staff plan to launch a 360-degree video immersion experience.  

“By immersing learners in a realistic virtual environment, we believe trainees will show greater retention of the difficult airway algorithm,” said Raza Zaidi, M.D., clinical assistant professor and the project’s faculty lead. “We believe extended reality (XR) will be effective in providing an authentic clinical environment, allowing them to practice a stressful scenario in a safe space without risk of patient harm.”

The project is one of 13 funded this year through the University of Michigan Center for Academic Innovation’s XR Innovation Fund. The fund, part of the center’s three-year XR Initiative, seeds projects that integrate extended reality (XR) into curriculum.

“The XR Initiative is very excited to be partnering with the Medical School and Dr. Zaidi on this very important project,” said Jeremy Nelson, director of the XR Initiative. “We believe that these immersive technologies can help enhance teaching and learning in new and innovative ways to practice high-risk situations in low-risk environments. We look forward to the great work Dr. Zaidi and the team create.”

The Anesthesiology XR team includes Zaidi, Simulation Director Liz Putnam, M.D., Clinical Assistant Professor Sam Schechtman, M.D., and Education Specialist Lara Zisblatt, Ed.D.

The team already has developed a video of a difficult airway simulation using a 360-degree camera. Grant funding will allow them to license an immersive reality platform for the video, providing trainees with anytime, anywhere access to a virtual learning environment.

So, how does it work?

With a 360-degree video, learners use a virtual reality headset, phone or tablet to navigate the room in any direction they choose. They’re in the driver’s seat as they click on the video to highlight various items, identify risks, or show next steps. Instructors also can add questions and reflection topics to mimic two-way interaction throughout the video. 

“This is not just about teaching a particular skill, but allowing a learner to experience an environment and all the different elements happening simultaneously,” Zaidi said. “This is useful in showing how a crisis unfolds and teaches nontechnical skills such as situational awareness, effective communication, coordination, and leadership.”

Zaidi said simulations through the Clinical Simulation Center will continue to play a critical role in the learning experience, but the need for dedicated space and personnel can create logistical challenges — something they saw play out even more as COVID-19 limited in-person teaching sessions.

The team will assess the educational value of the platform throughout its initial run. If all goes well, they believe this XR experience could be the start of additional immersive learning practices, both within the department and throughout Michigan Medical School.

“The Department of Anesthesiology has prioritized simulation education as a major part of our curriculum,” Zaidi said, “and we are committed to developing an innovative, fun, and engaging virtual curriculum for our learners.”