Background. In this pilot study, we evaluated tip collisions against three commonly used measures of fibreoptic scope handling skills. Methods. Seventy-seven anaesthetists were recruited to perform a standardized task on an Oxford Box and a modified AirSim manikin. Collision count was correlated against time to scope placement, a global rating scale score, and up-to-date fibreoptic experience. Results. Strong and moderate correlations were found between collision count and task completion time for the Oxford Box (ρ = 0.730, P < 0.0001) and AirSim manikin (ρ = 0.405, P < 0.0001), respectively. Moderate correlation was found between collision count and global rating scale score for the Oxford Box (ρ = ？0.545, P < 0.0001) and AirSim manikin (ρ = ？0.500, P < 0.0001). Mild and moderate correlations were found between collision count and fibreoptic experience on the Oxford Box (ρ = ？0.240, P = 0.041) and AirSim manikin (ρ = ？0.423, P < 0.0001), respectively. Conclusions. This study infers that collision count may be used as a measure of fibreoptic scope handling skills in simulation training. Using this outcome in addition to other measures of performance may improve accuracy and precision of fibreoptic scope placement. 1. Introduction Fibreoptic intubation is a core anaesthetic airway skill. It is internationally accepted as an important tool in the management of the difficult airway [1, 2]. Traditionally it has been taught using the apprenticeship model. However, anaesthetists may require 25 fibreoptic training opportunities to gain proficiency [3] when the number of patients with anticipated difficult laryngoscopy requiring fibreoptic intubation is limited. Trainees find it difficult to gain sufficient patient experience; consequently the skill is increasingly taught on manikins and other teaching devices. Previous studies on fibreoptic intubation training have used outcome measures such as success rates [3, 4] and/or time to fibreoptic scope guided tracheal intubation [4–6]. However, these quantitative measures give limited information on the subject’s performance and skill [6]. Other outcome measures, such as global assessment scales and check lists [3, 4], have been used to evaluate fibreoptic scope intubation training. Maintaining a clear view and avoiding collision with pathological structures may be more important than speed of intubation and may be a better measure of fibreoptic scope handling skill [7]. The number of times the bronchoscope makes contact with the airway wall with loss of view has been used as an outcome measure of handling skills in
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