PURPOSE: Endobronchial ultrasound (EBUS) is a relatively new technique that is increasingly becoming incorporated into clinical practice. For the past 4 years, we have offered a hands-on EBUS course to physicians. The purpose of this study was to evaluate course participants’ : 1- knowledge of EBUS; 2- incorporation of EBUS procedures into clinical practice; 3- opinions regarding barriers to the implementation of EBUS.
METHODS: We developed an on-line survey that was distributed to all previous course participants (2007-2009) a minimum of one year following attendance at the course.
RESULTS: Overall survey response rate was 51%. 82% of respondents were respirologists and 18% thoracic surgeons. 54% of participants had completed additional EBUS training or courses. Overall, 36% of respondents reported currently performing linear EBUS, with an average volume of 5.5 procedures per month, and 54% either performed EBUS or had access to the technique through another physician in their center. In their current practice, 40% of participants would use EBUS in the work-up of a patient with suspected stage 1 sarcoidosis; 44% for evaluation of an enlarged paratracheal lymph node in a patient with lung adenocarcinoma; and 35% in the workup of a suspected lung cancer patient with bulky mediastinal lymphadenopathy. Participants scored 100% and 92% on two questions testing knowledge of EBUS. Course participants identified several barriers to the implementation of EBUS in their centers, including cost of equipment (73%) and inadequate support staff (32%). None of the respondents felt that inadequate patient volume for EBUS was a barrier to its implementation.
CONCLUSION: Participation in a dedicated EBUS course is associated with excellent knowledge surrounding the technique, but almost 2/3 of attendees are still not performing the procedure 1-3 years after having attended. Cost of equipment acquisition was the most commonly cited barrier to implementation of the technique and only 14% cited lack of training as a significant barrier.
CLINICAL IMPLICATIONS: Barriers beyond physician training may be more important in limiting the implementation of EBUS into clinical practice.
DISCLOSURE: Natasha Sabur, 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. Tremblay has received consulting fees from Olympus America.; No Product/Research Disclosure Information