SESSION TITLE: Bronchoscopic Training and Approaches
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Sunday, October 27, 2013 at 10:45 AM - 11:45 AM
PURPOSE: When proctored by an interventional pulmonologist, computer endobronchial ultrasound (EBUS) simulators have been demonstrated to improve trainee procedural skills before attempting to perform EBUS procedures on patients. This study aims to compare EBUS performance following training with computer simulation proctored by EBUS trained respiratory therapists versus the same simulation training proctored by an interventional pulmonologist.
METHODS: A prospective study of pulmonary medicine trainees learning EBUS. Two cohorts of trainees were evaluated using a previously validated method utilizing simulated cases with performance metrics measured by the simulator. Group 1 underwent EBUS training by performing 15 cases on an EBUS simulator (n=4) proctored by an interventional pulmonologist. Group 2 received identical training proctored by a respiratory therapist with special training in EBUS (n=10).
RESULTS: No significant differences between group 1 and group 2 were seen for the primary outcome measures of total procedure time [15.15(+/-1.34) vs. 14.78(+/-2.88) minutes, p=0.816], the percentage of lymph nodes successfully identified [88.8(+/-5.4) vs. 80.91(+/-8.9), p=0.920], or the percentage of successful biopsies [100.0(+/-0.0) vs. 98.75(+/-3.95), p=0.549]. The learning curves were similar between groups, and did not show an obvious plateau after 19 simulated cases in either group.
CONCLUSIONS: Acquisition of basic EBUS technical skills can be achieved using computer EBUS simulation proctored by specially trained respiratory therapists or by an interventional pulmonologist. There appears to be no significant advantage to having an interventional pulmonologist proctor computer EBUS simulation as compared to respiratory therapists with special training in EBUS.
CLINICAL IMPLICATIONS: Given the significant learning curve and the substantial amount of time required to learn this challenging technique, this novel approach of utilizing specially trained respiratory therapists to teach EBUS provides a more cost-effective, sustainable method of teaching EBUS to trainees.
DISCLOSURE: The following authors have nothing to disclose: David Stather, Alex Chee, Paul MacEachern, Elaine Dumoulin, Christopher Hergott, Jacob Gelberg, Sandra Scott, Sylvia De Guzman, Alain Tremblay
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