Open AccessArticle
Effect of Cognitive Distractors on Neonatal Endotracheal Intubation Performance: Insights from a Dual-Task Simulator
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Yan Meng, Shang Zhao, Xiaoke Zhang, John Philbeck, Prachi Mahableshwarkar, Boyuan Feng, Lamia Soghier and James Hahn
Virtual Worlds 2025, 4(2), 20; https://doi.org/10.3390/virtualworlds4020020 (registering DOI) - 20 May 2025
Abstract
Neonatal endotracheal intubation (ETI) is a complex medical procedure that demands extensive training before practicing on real patients. Clinical studies indicate that the conventional training approach, typically conducted in idealized conditions with task trainers, has a low skill transferability rate compared to performance
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Neonatal endotracheal intubation (ETI) is a complex medical procedure that demands extensive training before practicing on real patients. Clinical studies indicate that the conventional training approach, typically conducted in idealized conditions with task trainers, has a low skill transferability rate compared to performance in the dynamic environments common in intensive care units (ICUs). According to cognitive load theory, novices encounter difficulties in multitasking scenarios, exhibiting performance declines due to competition among tasks for cognitive resources; experts, having achieved automaticity, have more cognitive resources to handle additional tasks present in high-stress environments and therefore exhibit less performance degradation. Current ETI skill assessment methods do not capture these differences in expertise. To bridge this gap, we develop an innovative dual-task mixed-reality (MR) simulator to evaluate the influence of cognitive distractors on ETI and substantiate effective performance measurement metrics. Results affirm that experts demonstrate superior proficiency in handling extraneous cognitive loads compared to novices. This has important implications for understanding how to measure novice performance in ETI settings. Taken together, the dual-task ETI training simulator and the associated automated skill evaluation metric system hold promise for enhancing training in neonatal ETI practice and ultimately leading to improved patient care outcomes.
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