Objectives: To determine current pulmonary
fellows’ perspectives about their bronchoscopy training.
Design: Survey of 59 pulmonary fellows selected by training
program directors to represent their institutions.
Setting: “Hands-on” symposium at the CHEST 1998 annual
meeting, Toronto, Canada.
Results: Fellows reported a
mean (± SD) of 2.4 ± 0.7 years of training, estimated they had
performed 77.7 ± 34 bronchoscopies per year, and had generally high
estimates of their bronchoscopy proficiency and training. Proficiency
estimates correlated with number of procedures cited (r = 0.43,
p = 0.001) or level of fellowship training (r = 0.40, p = 0.002).
Proficiency ratings (r = 0.63, p = 0.0001) and procedure numbers
(r = 0.45, p-0.0004) correlated with program quality ratings.
Approaches to bronchoscopy instruction varied, and most often consisted
of one-to-one instruction by faculty (92.5%), lecture-based
instruction (74.6%), and case discussions (72.9%). Use of
bronchoscopy lectures (p = 0.008) or videos (p = 0.057) were
associated with higher self-estimates of proficiency, whereas use of
lectures (p = 0.002), a bronchoscopy text (p = 0.009), and
one-on-one instruction (p = 0.05) were associated with more highly
ranked programs. Major components of training varied among programs.
Although most fellows had received instruction encompassed in basic
bronchoscopy, fewer had experience with bronchoscopic intubation
(71.2%), transbronchial needle aspiration (72.9%), quantitative
bacterial culture (64.4%), stent placement (27.1%), laser
photocoagulation (25.4%), or cryotherapy (6.8%). Components of
bronchoscopy experiences correlated with fellows’ estimates of
bronchoscopy proficiency and program quality.
Conclusions: Approaches to bronchoscopy instruction and the
components of bronchoscopy experiences vary considerably among
institutions and are associated with pulmonary fellows’ perceptions of
bronchoscopy proficiency and training program quality. Definition of an
optimum bronchoscopy curriculum remains