PURPOSE: The number of lung transplants has increased significantly, with a U.S. annual transplantation rate of over 2000. The major factor limiting more transplants is donor-lung availability, with many patients dying on the waiting list. Organ procurement coordinators (OPCs) play a vital role in this process. Preliminary studies have shown that thoracic organ allocation rates can be increased by broadening the scope of practice of OPCs using additional training in advanced skills such as bronchoscopy. We set out to create and pilot-test a simulator-based curriculum in bronchoscopy, alongside other skills necessary for enhancing the lung allocation process.
METHODS: Four OPCs participated in the training course. The mainstay of the course was four hours of one-on-one training for each OPC on a bronchoscopy virtual reality simulator (VRS), along with time for unsupervised practice. This training was based on the Bronchoscopy Step-by-Step© curriculum, (http://bronchoscopy.org/). In addition, the OPCs received didactic lectures on related topics (such as chest-radiograph and blood-gas interpretation), and were encouraged to use the web-based Essential Bronchoscopist©. Bronchoscopy skills were tested on the VRS, using an instrument devised and validated by the authors (the BSET; Bronchoscopy Stepwise Evaluation Tool). The didactic curriculum was tested using a written test.
RESULTS: The trainees’ scores on the BSET varied widely, and were proportional with each trainees’ hours of VRS-based practice: 44/100 for one hour of practice versus 82/100 for four hours. The results of the didactic test correlated with the BSET scores, suggesting a correlation between the trainees’ incentive for VRS-based practice and home-study time.
CONCLUSION: The OPCs showed strong motivation in learning diagnostic bronchoscopy on a VRS. With minimal resources and time, OPCs can be trained using a VRS-based curriculum to perform diagnostic, and perhaps simple therapeutic bronchoscopy.
CLINICAL IMPLICATIONS: By building upon this limited experience, an advanced training course for OPCs, with special emphasis on VRS-based bronchoscopy training can be created, leading to a wider scope of practice. We hope that this will result in an improved thoracic organ allocation rate.
DISCLOSURE: Mohsen Davoudi, None.