283 © Springer Nature Switzerland AG 2020 B. Mahoney et al. (eds.), Comprehensive Healthcare Simulation: Anesthesiology, Comprehensive Healthcare Simulation, https://doi.org/10.1007/978-3-030-26849-7_24 Simulation in Otolaryngology and Airway Procedures Christine Lan Mai, Maricela Schnur, and Adam I. Levine Introduction The feld of anesthesiology has become increasingly sub- specialized, with unique challenges that demand high-quality teaching and training. Advancements in technology have ensured higher standards for patient safety, quality, and eff- ciency within the traditional operating room and in remote sites. While many surgical environments beneft from a colle- gial team dynamic, the characteristics of the otolaryngologic environment require a unique interdisciplinary collabora- tion for optimal patient outcomes [1]. Anesthesiologists and otolaryngologists work quite literally side by side and share overlapping concerns and physical space. Patients undergo- ing head and neck surgery can also be at high risk for poten- tially devastating events if the airway anatomy is distorted from pathologic conditions or previous surgical interven- tions. Therefore, both specialties beneft from a shared com- prehensive understanding of each other’s practice. Most of the current ear, nose, and throat (ENT) simulation education literature is focused on improvement of procedural skills or sub-specialty training, either for the surgeon or anes- thesia provider alone [2, 3]. Clearly, this is not suffcient for prevention or management of high-stress situations where crisis resource management and interdisciplinary communi- cation skills can affect patient outcomes. High-quality ENT anesthesia simulation should provide several things to clini- cians including (1) deliberate practice of procedural skills and/ or (2) familiarization with equipment and their failure modes, (3) management of basic and critical events associated with ENT patients and surgery, (4) interdisciplinary crisis resource management skills during head and neck surgery including decision-making under pressure and delegation of roles, and (5) debriefng, refection, and valuable feedback [3]. In this chapter we will review the current simulation technology and describe ways to incorporate them into an educational experi- ence to enrich technical and nontechnical skills. Finally, we will conclude with a completely developed scenario of an air- way fre and list other examples of scenario stems that can be used for anesthesiology training or developed to include multi- disciplinary training with our surgical and nursing colleagues. Review of Procedural Airway Devices Although basic and advanced airway management is ubiqui- tous for the training of all anesthesiologists, ENT anesthesia (with its patient population and specifc surgical proce- dures) requires profciency of both noninvasive and invasive techniques. An assortment of devices can be utilized based on the characteristics of each technology and the clinical lessons that are desired [4]. Simulation devices are divided into two broad categories, partial-task trainers and whole- task trainers. Partial-task trainers are models designed to allow participants to practice clinical skills and tasks; many are simple devices designed for learning or practicing spe- cifc procedures (e.g., mask ventilation, laryngoscopy, needle cricothyrotomy). Others are sophisticated devices that are coupled with computer and robotic interfaces, which can enhance the physical and virtual aspects of the simulators for practicing more complex procedures (e.g., bronchoscopy and endoscopy). These devices are useful 24 C. L. Mai (*) Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA e-mail: CMAI1@mgh.harvard.edu M. Schnur Interventional Pain Management, St. Luke’s, Duluth, MN, USA Department of Anesthesiology, Perioperative and Pain Medicine, Department of Otolaryngology, and Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York City, NY, USA A. I. Levine Department of Anesthesiology, Perioperative and Pain Medicine, Department of Otolaryngology, and Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York City, NY, USA