PURPOSE: Variation in medical procedural training exists, sometimes resulting in inadequate procedural training. Assessment of competency for medical procedures is an area of great interest. Endobronchial ultrasound (EBUS) is a revolutionary minimally invasive diagnostic pulmonary procedure. This study aims to validate a computer EBUS simulator in differentiating between operators of varying clinical EBUS experience.
METHODS: A convenience sample (n=22) of bronchoscopists were evaluated and separated into four cohorts based on previous clinical EBUS and bronchoscopy experience: group A = novice bronchoscopists with no EBUS experience (0 prior EBUS procedures, n=4), group B = expert bronchoscopists with no EBUS experience (0 prior EBUS procedures, n=5), group C = basic clinical EBUS training (>15 and <25 prior EBUS procedures, n=9), and group D = EBUS experts (>200 prior EBUS procedures, n=4). None of the participants had prior experience using an EBUS simulator. After a standardized introduction session on the EBUS simulator, each participant performed 2 simulated cases on an EBUS simulator with performance metrics being measured by the simulator. Outcome measures recorded were: total procedure time, percentage of lymph nodes identified, and percentage of successful biopsies.
RESULTS: Significant differences between groups were noted for all 3 outcome measures (p<0.05 ANOVA. Main Results SD). Group D performed significantly better than all other groups for all outcome measures except for percentage successful biopsies compared to group C. Group C also performed significantly better than groups A and B for all 3 outcome measures. The only significant difference noted between groups A and B was a shorter procedure time in group B.
CONCLUSION: The EBUS simulator can accurately discriminate between operators with different levels of clinical EBUS experience.
CLINICAL IMPLICATIONS: By demonstrating that EBUS simulators can accurately discriminate between operators with different levels of clinical EBUS experience, this study supports the use of EBUS simulators as a tool for assessing training and evaluating competency.
DISCLOSURE: David Stather, Grant monies (from industry related sources) The University of Calgary has received grants from Olympus Canada for support of an Interventional Pulmonary Medicine Training Program and for CME events relating to EBUS.; Consultant fee, speaker bureau, advisory committee, etc. Dr. A. Tremblay has received consulting fees from Olympus America.; No Product/Research Disclosure Information