Pediatric and neonatal airway management skills are life-saving, difficult to master, and used infrequently enough to make skill maintenance a serious challenge. For example, multiple studies have shown that pediatric and neonatal intubation procedures are often successful less than half of the time, especially among residents. Given the long skill acquisition cycles (in spite of modern simulation training), new training methodologies are required. In recent years, there has widespread adoption of patient simulators in the medical education community. The didactic value of these simulators could be significantly improved if the trainee was able to understand the location of internal landmarks, as well as visualize normal and pathological states of the body during training. This would help trainees understand the relationship between their actions and what is occurring in the body. ArchieMD proposes to develop a pediatric airway mixed reality medical simulation system to combine multimedia technologies with manikins to enable internal anatomy overlays on medical trainers. Using mixed reality tracking, ArchieMD's 3D imagery of the body's internal anatomy can be superimposed over the view of the user, providing additional 3D didactic information while using a task trainer manikin. The resulting overlayed video stream is then displayed on a widescreen monitor. This provides highly effective synergy between the visual and hands-on component of medical education. Optical sensors allow integration of the medical equipment with the anatomy models and the manikin while the procedures are being conducted. This results in a realistic anatomic and physiologic representation of the patient. The training system will include tablet (iPad)-based skills that are relevant to the training to ensure that trainees make effective use of limited training time. Further, it should be noted that the immediate visual feedback allows for practice without an evaluator present. Finally, the videostream can be captured for post-training or remote critique by an evaluator. The specific aims of this Phase I project are (1) Develop prototype mixed-reality trainers for pediatric and neonatal intubation; and (2) Conduct a preliminary evaluation of the prototype mixed- reality trainers to determine impact on skills, while also assessing qualitative metrics.