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Twenty-Five Questions: An Important Step on a Critical Journey

Mark E. Lund, MD, FCCP
Author and Funding Information

Correspondence to: Mark E. Lund, MD, FCCP, Drexel University College of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, 245 N 15th St, Mailstop 107, Philadelphia, PA 119102; e-mail: mlund@drexelmed.edu

Dr. Lund is Assistant Professor, Drexel University College of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine.


The author has reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(2):256-258. doi:10.1378/chest.08-2342
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Extract

Bronchoscopic examination of the tracheobronchial tree and associated diagnostic procedures are the trademark of most pulmonologists. The bronchoscope has been transitioning over the last 25 years from a purely diagnostic instrument to a therapeutic tool. The ability to advance from airway inspection to diagnostic procedures and subsequently to therapeutic interventions is reliant on the development of an appropriate skill set. Our pedagogic paradigm began with Sir William Halstead, when he introduced the German-style residency of apprenticeship with graded responsibility to Johns Hopkins University in the 1890s. The pedagogic approach involves a significant plasticity that provides several benefits, including the following: real-time feedback; flexibility for skills acquisition; and adaptability to regional or institutional missions. However, the appropriateness of the “see one, do one, teach one” approach is now being questioned in many procedural specialties.

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