PURPOSE: As the number of procedures in the interventional pulmonary armamentarium increases, educators have increasingly developed focused structured courses to train interested physicians. It has not been demonstrated whether such short focused curricula are effective in conferring competency to their trainees. We hypothesized that a two-day structured course in pleuroscopy/thoracoscopy can improve the knowledge and skills of trainees, and that this knowledge and skill acquisition can objectively be measured using competency-based assessment tools.
METHODS: The first day consisted of ten lectures and three question-answer panels on anatomy and imaging, diagnostic algorithms, indications and contraindication, strategizing, technique and anesthesia, and response to complications; the procedures were discussed as they pertain to the most prominent clinical settings, including benign, malignant and paramalignant pleural effusions, parapneumonic effusions and empyema, and mesothelioma. The second day consisted of eight hours of hands-on skill stations on patient-positioning, flex-rigid pleuroscopy, rigid videothoracoscopy, trocar and chest tube insertion and suturing. Before the first lecture, a 35-item multiple-choice question (MCQ) test was administered; the same test was repeated at the end of day two. Technical skill was tested at the videothoracoscopy simulation station before day two, and at the end of the day.
RESULTS: The MCQ test scores of the 17 participants showed an average improvement of 7.8 points (out of 35 points, a mean increase of 22%; p<0.001) [Figure-1]. Skills tests scores demonstrated an average increase of 2.65 points (out of 8 points, a mean increase of 33%) despite the fact that the time allotted for the assigned simulated videothoracoscopic task was one minute (33%) shorter [Figure-2].
CONCLUSION: A two-day focused course in pleuroscopy/thoracoscopy resulted in significant acquisition of knowledge and skills by the participants. We demonstrated 22–33% improvement in two measurable competencies: theoretic knowledge, and one specific skill (manipulation of a videothoracoscope inside a simulated thoracic space).
CLINICAL IMPLICATIONS: Objective measures can be used to demonstrate the acquisition of knowledge and skills during procedure-related courses within a competency-based paradigm.
DISCLOSURE: Mohsen Davoudi, No Financial Disclosure Information; No Product/Research Disclosure Information