PURPOSE: Variation in medical procedural training exists, sometimes resulting in inadequate procedural training. Endobronchial ultrasound (EBUS) is a revolutionary minimally invasive diagnostic pulmonary procedure. The use of a computer EBUS simulator could improve the rate of procedural skill acquisition, and improve technical skill competence in pulmonary medicine trainees before the trainees attempt to perform such procedures during patient care experiences. This study aims to compare EBUS performance following training with EBUS simulation versus conventional EBUS training using patients.
METHODS: A prospective study of pulmonary medicine and thoracic surgery trainees. Two cohorts of trainees were evaluated using simulated cases with performance metrics being measured by the EBUS simulator. Group 1 received EBUS training by performing 15 cases on an EBUS simulator (n=4). Group 2 received EBUS training by doing 15-25 EBUS cases on patients (n=9).
RESULTS: Total procedure time in minutes was significantly shorter in group 1 than group 2 [ 15.15(+/-1.34) vs. 20.00(+/-3.25) p< 0.05]. The percentage of lymph nodes successfully identified was significantly better in group 1 than group 2 [ 89.8(+/-5.4) vs. 68.1(+/-5.2) p< 0.05]. There was no difference between group 1 and group 2 in the percentage of successful biopsies [100.0(+/-0.0) vs. 90.4(+/-11.5) p=0.13]. There was no difference between group 1 and group 2 in time to intubation with the EBUS bronchoscope in minutes [0.71(+/-0.29) vs. 1.41(+/-0.71) p=0.09].
CONCLUSION: The use of an EBUS simulator leads to more rapid acquisition of expertise in EBUS compared with conventional training methods using clinical cases, as assessed by an EBUS simulator.
CLINICAL IMPLICATIONS: EBUS simulators show promise for training and evaluating competency and have the added advantage of minimizing the burden of procedural learning on patients in academic institutions. Further studies are required to determine if the skills acquired on the EBUS simulator are transferable to clinical procedures.
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