Tracheal intubation in emergency and complex scenarios is difficult for critical care medicine residents.Virtual reality(VR)technology has not been used in the training of tracheal intubation in critical care scenarios in China.This project team has developed an emergency tracheal intubation training system for the intensive care unit(ICU)based on virtual simulation technology,and has obtained the computer software copyright registration certificate from the National Copyright Administration(registration number:2024SR1139484).This system uses a case script of acute respiratory distress syndrome(ARDS)secondary to severe acute pancreatitis,sets the roles of patients,family members,nurses and residents,collects digital resources of ICU rescue scenes,computer-aided design(CAD)drawings,instrument models and equipment photos,models instruments and equipment,and uses PICO 4 Pro VR helmets to display the ICU environment in the virtual scene.The key points of skill assessment include tracheal intubation operation,the ability to interpret laboratory results,the ability to judge diseases and the ability to work in teams.The user center contains 3 submodules,namely,the score center,skill analysis and user management.There are 3 user roles in the system,namely,residents,teachers and administrators.The system can track and record the entire operation process,including video recording and playback,and score and comprehensively evaluate each step,thereby realizing an objective and quantitative training and assessment system.By simulating the three-dimensional clinical operation environment of the ICU,the entire process of real tracheal intubation is fully reproduced.Resident doctors are placed in the ICU rescue scene,focusing on training tracheal intubation skills,the ability of doctor-patient communication,on-the-spot response,and teamwork,which is expected to become an important type of standardized teaching in critical care medicine.

Objective To explore the effectiveness of a tracheal intubation training system based on virtual reality(VR)technology in cultivating the clinical practice abilities of resident physicians.Methods Twenty-five first-year resident physicians who were enrolled in the residency programme at Peking University Third Hospital from August 2024 to February 2025 were recruited for this study.All participants completed a questionnaire after receiving VR-based intensive care unit(ICU)emergency tracheal intubation training,to share their experiences with the VR technology-based ICU emergency tracheal intubation training and the shortcomings encountered during the process.Results ① General information:a total of 25 resident physician questionnaires were distributed in this study and received 25 valid responses(response rate 100%).Among the 25 residents,there were 15 males(60%)and 10 females(40%),with an average age of(25.3±0.8)years.Clinical experience was categorised as≤1 year 4 residents(16%),>1-3 years 8 residents(32%),>3-<5 years 5 residents(20%)and≥5 years 8 residents(32%).Among them,3 residents(12%)had no prior tracheal intubation experience,while 11(44%)had performed>10 intubations.Prior to this training,3 residents(12%)had received other forms of virtual tracheal intubation training,whereas 22(88%)had not.During traditional tracheal intubation training,18 residents(72%)reported that they monitored heart rate and blood pressure,whereas 7(28%)did not.In real-world emergency tracheal intubation scenarios,21 residents(84%)experienced role confusion.Additionally,23 residents(92%)believed that opportunities for tracheal intubation practice were too limited,17(68%)thought traditional training provided more guidance from instructors,and 15(60%)valued practical operation opportunities more in tracheal intubation training.②VR-based ICU emergency tracheal intubation training experience:23 residents(92%)considered the VR-based ICU emergency tracheal intubation training effective,with 13(52%)believing it to be more effective than traditional training.Furthermore,23 residents(92%)felt that the VR-based training created a more relaxed learning atmosphere,heightened their interest in learning tracheal intubation,and had better future prospects;22 residents(88%)believed that VR technology facilitated a better understanding of the laryngeal structure;24 residents(96%)thought that VR-based training reduced practical operation risks and better simulated real-world conditions;16 residents(64%)were highly satisfied with the VR-based ICU emergency tracheal intubation operating system;24 residents(96%)considered the case scenarios in the VR-based training reasonable.17 residents(68%)believed that VR-based training offered more learning opportunities,and 19 residents(76%)thought it reduced anxiety during the intubation process.③ Disadvantages of VR-based ICU emergency tracheal intubation:9 residents(36%)tended to overlook obtaining family consent before emergency tracheal intubation prior to the training.Regarding interactivity,5 residents(20%)rated it as excellent,9(36%)as average,and 11 residents(44%)believe that the interactivity was poor;22 residents(88%)felt a lack of tactile feedback during practical operations;20 residents(80%)recommended adding more simulated scenarios;11 residents(44%)believed that,compared to traditional training,VR training lacked practical operation opportunities.Additionally,17 residents(68%)experienced discomfort such as dizziness during the operation.Conclusion VR-based intubation training effectively enhances technical proficiency and psychological preparedness in ICU clinicians,particularly in anatomical visualization and risk-controlled rehearsal.

Tracheal intubation in emergency and complex scenarios is difficult for critical care medicine residents.Virtual reality(VR)technology has not been used in the training of tracheal intubation in critical care scenarios in China.This project team has developed an emergency tracheal intubation training system for the intensive care unit(ICU)based on virtual simulation technology,and has obtained the computer software copyright registration certificate from the National Copyright Administration(registration number:2024SR1139484).This system uses a case script of acute respiratory distress syndrome(ARDS)secondary to severe acute pancreatitis,sets the roles of patients,family members,nurses and residents,collects digital resources of ICU rescue scenes,computer-aided design(CAD)drawings,instrument models and equipment photos,models instruments and equipment,and uses PICO 4 Pro VR helmets to display the ICU environment in the virtual scene.The key points of skill assessment include tracheal intubation operation,the ability to interpret laboratory results,the ability to judge diseases and the ability to work in teams.The user center contains 3 submodules,namely,the score center,skill analysis and user management.There are 3 user roles in the system,namely,residents,teachers and administrators.The system can track and record the entire operation process,including video recording and playback,and score and comprehensively evaluate each step,thereby realizing an objective and quantitative training and assessment system.By simulating the three-dimensional clinical operation environment of the ICU,the entire process of real tracheal intubation is fully reproduced.Resident doctors are placed in the ICU rescue scene,focusing on training tracheal intubation skills,the ability of doctor-patient communication,on-the-spot response,and teamwork,which is expected to become an important type of standardized teaching in critical care medicine.

Objective To explore the effectiveness of a tracheal intubation training system based on virtual reality(VR)technology in cultivating the clinical practice abilities of resident physicians.Methods Twenty-five first-year resident physicians who were enrolled in the residency programme at Peking University Third Hospital from August 2024 to February 2025 were recruited for this study.All participants completed a questionnaire after receiving VR-based intensive care unit(ICU)emergency tracheal intubation training,to share their experiences with the VR technology-based ICU emergency tracheal intubation training and the shortcomings encountered during the process.Results ① General information:a total of 25 resident physician questionnaires were distributed in this study and received 25 valid responses(response rate 100%).Among the 25 residents,there were 15 males(60%)and 10 females(40%),with an average age of(25.3±0.8)years.Clinical experience was categorised as≤1 year 4 residents(16%),>1-3 years 8 residents(32%),>3-<5 years 5 residents(20%)and≥5 years 8 residents(32%).Among them,3 residents(12%)had no prior tracheal intubation experience,while 11(44%)had performed>10 intubations.Prior to this training,3 residents(12%)had received other forms of virtual tracheal intubation training,whereas 22(88%)had not.During traditional tracheal intubation training,18 residents(72%)reported that they monitored heart rate and blood pressure,whereas 7(28%)did not.In real-world emergency tracheal intubation scenarios,21 residents(84%)experienced role confusion.Additionally,23 residents(92%)believed that opportunities for tracheal intubation practice were too limited,17(68%)thought traditional training provided more guidance from instructors,and 15(60%)valued practical operation opportunities more in tracheal intubation training.②VR-based ICU emergency tracheal intubation training experience:23 residents(92%)considered the VR-based ICU emergency tracheal intubation training effective,with 13(52%)believing it to be more effective than traditional training.Furthermore,23 residents(92%)felt that the VR-based training created a more relaxed learning atmosphere,heightened their interest in learning tracheal intubation,and had better future prospects;22 residents(88%)believed that VR technology facilitated a better understanding of the laryngeal structure;24 residents(96%)thought that VR-based training reduced practical operation risks and better simulated real-world conditions;16 residents(64%)were highly satisfied with the VR-based ICU emergency tracheal intubation operating system;24 residents(96%)considered the case scenarios in the VR-based training reasonable.17 residents(68%)believed that VR-based training offered more learning opportunities,and 19 residents(76%)thought it reduced anxiety during the intubation process.③ Disadvantages of VR-based ICU emergency tracheal intubation:9 residents(36%)tended to overlook obtaining family consent before emergency tracheal intubation prior to the training.Regarding interactivity,5 residents(20%)rated it as excellent,9(36%)as average,and 11 residents(44%)believe that the interactivity was poor;22 residents(88%)felt a lack of tactile feedback during practical operations;20 residents(80%)recommended adding more simulated scenarios;11 residents(44%)believed that,compared to traditional training,VR training lacked practical operation opportunities.Additionally,17 residents(68%)experienced discomfort such as dizziness during the operation.Conclusion VR-based intubation training effectively enhances technical proficiency and psychological preparedness in ICU clinicians,particularly in anatomical visualization and risk-controlled rehearsal.