Impact of Video Games and Activities on Videolaryngoscopy Success

Overview

This study aims to investigate the factors influencing the videolaryngoscopy success among fourth-year medical students participating in anesthesia clerkship. Specifically, it examines the impact of activities such as video gaming and various other hobbies on fundamental skills related to videolaryngoscopy, including hand-eye coordination, motor skills, visual attention, and spatial awareness. In this context, the study evaluates how regular engagement in activities such as video games, sports, chess, Rubik's Cube, 3D puzzles, arts and crafts, and playing musical instruments may contribute to intubation success, intubation duration, and the quality of glottic visualization.

Research will include fourth-year students who are volunteering and have no prior endotracheal intubation experience, during the 2025-2026 academic year at Tokat Gaziosmanpaşa University Faculty of Medicine's Department of Anesthesiology. Students with previous clinical airway management experience-such as videolaryngoscopy (VL) or direct laryngoscopy intubation-will be excluded, particularly those unable to utilize VL due to motor impairments (e.g., neuromuscular disorders) or recent hand surgeries. Students will be enrolled after receiving information about the study and providing informed consent. Prior to participation, all students will receive theoretical training on airway management and videolaryngoscopy-assisted intubation. Following the theoretical instruction, practical skills training will be conducted on mannequins using videolaryngoscopy for intubation. Students who agree to participate will then perform an intubation attempt on a standard airway management mannequin using videolaryngoscopy. Data collected will include demographic characteristics, habits such as video gaming, sports activities, participation in board games like chess, Rubik's Cube, three-dimensional puzzles, and hobbies such as arts and crafts or playing musical instruments. Additionally, parameters such as intubation success (successful/unsuccessful), intubation duration (in seconds), glottic visualization scores (Cormack-Lehane classification and POGO score), and the durations of two specific phases of intubation (glottic visualization time and endotracheal tube passage time) will be recorded. The study aims to investigate the influence of video game playing habits and certain activities on videolaryngoscopic intubation performance. Glottic visualization will be assessed using the Cormack-Lehane grading system, where Grade I indicates full visualization of the glottis, Grade IIa signifies partial visibility, Grade IIb corresponds to only arytenoid cartilages being visible, Grade III indicates only the epiglottis is seen, and Grade IV denotes no visible glottic structures. The POGO (Percentage of Glottic Opening) score provides a quantitative measure of the proportion of the glottic opening visible during intubation, expressed as a percentage. A POGO score of 100% indicates complete visualization of the glottic opening (from anterior commissure to posterior arytenoids), while a score of 0% indicates no glottic structures are visible (only the epiglottis can be seen). A score of 50% reflects that half of the glottic opening is visible. The total intubation time is defined as the interval from the beginning of the procedure-placing the laryngoscope blade into the mouth-to the successful placement and confirmation of the endotracheal tube within the trachea. The glottic visualization time refers to the duration from insertion of the laryngoscope into the mouth until the initial clear view of the glottis is obtained. The endotracheal tube passage time is measured from the moment the glottic structures are visualized until the tube passes through the vocal cords into the trachea.