Basic Bronchoscopy Competence Achieved by a Nationwide One-day Simulation-based Training

Journal of Bronchology & Interventional Pulmonology, vol. 32

Abstract

BACKGROUND: In 2020, a mandatory, nationwide 1-day bronchoscopy simulation-based training (SBT) course was implemented for novice pulmonology residents in the Netherlands. This pretest-posttest study was the first to evaluate the effectiveness of such a nationwide course in improving residents' simulated basic bronchoscopy skills. METHODS: After passing a theoretical test, residents followed a 1-day SBT course, available in 7 centers, where they practiced their bronchoscopy skills step-by-step on a virtual reality simulator under pulmonologist supervision. Residents practiced scope handling efficiency (task 1) and navigational skills combined with lung anatomy knowledge (task 2). Task 1 outcome measures were navigational skill simulator metrics: percentage of time at mid-lumen, percentage of time with scope-wall contact, procedure time (PT), number of wall contacts and number of wall contacts per minute of PT. Task 2 outcome measures were PT, observational assessment scores of a validated tool with a 5-point scale (1 representing the worst and 5 the best competence) and blinded dexterity assessments. RESULTS: The study included 100 residents. All outcome measures of task 1 improved significantly (P<0.001), except for the number of wall contacts per minute of PT (4.3 [IQR 3.0 to 6.2] pre vs. 3.5 [IQR 2.6 to 5.3] post, P=0.07). For task 2, PT was reduced by 54% (10.3±2.7 minutes pre vs. 4.7±0.9 minutes post, P<0.001) with an improvement in overall-competence scores (2.0 [IQR 1.0 to 2.0] pre vs. 4.0 [IQR 4.0 to 5.0] post, P<0.001) and all dexterity parameters (P<0.001). CONCLUSION: Nationwide implementation of a SBT course led to rapid improvement of residents' basic bronchoscopy skills while halving PT.

Authors 18

1. Eveline C. F. Gerretsen corresponding

   Maastricht University

   Affiliation as printed

   Department of Educational Development and Research, School of Health Professions Education (SHE), Maastricht University, Maastricht

2. Marleen Groenier

   University of Twente

   Affiliation as printed

   Department of Technical Medicine, University of Twente, Enschede

3. Jouke Tabe Annema

   Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Department of Respiratory Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam

4. Erik H.F.M. van der Heijden

   Radboud University Nijmegen · Radboud University Medical Center

   Affiliation as printed

   Department of Respiratory Medicine, Radboudumc, Nijmegen

5. Walther van Mook

   Maastricht University Medical Centre · Maastricht University

   Affiliation as printed

   Academy for Postgraduate Training, Maastricht University Medical Center+, Maastricht

   Department of Intensive Care, Maastricht University Medical Center+, Maastricht

   School of Health Professions Education (SHE), Maastricht University, Maastricht

6. Arnoud F Aldenkamp corresponding

   Catharina Ziekenhuis

   Affiliation as printed

   Department of Respiratory Medicine, Catharina Hospital, Eindhoven

7. Emanuel Citgez

   Medisch Spectrum Twente

   Affiliation as printed

   Department of Respiratory Medicine, Medisch Spectrum Twente, Enschede

8. Laurence M.M.J. Crombag

   Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Department of Respiratory Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam

9. Wanda Hagmolen of ten Have

   Radboud University Nijmegen · Radboud University Medical Center

   Affiliation as printed

   Department of Respiratory Medicine, Radboudumc, Nijmegen

10. Birgitta I. Hiddinga

    University Medical Center Groningen

    Affiliation as printed

    Department of Pulmonary Medicine and Tuberculosis, University Medical Center Groningen, Groningen

11. Bart Hoppe Aachen Department of Respiratory Medicine

    Leiden University Medical Center

    Affiliation as printed

    Department of Respiratory Medicine, Leiden University Medical Center, Leiden

12. Maarten K. Ninaber Aachen Department of Respiratory Medicine

    Leiden University Medical Center

    Affiliation as printed

    Department of Respiratory Medicine, Leiden University Medical Center, Leiden

13. Marianne A. van de Pol

    Amsterdam University Medical Centers · University of Amsterdam

    Affiliation as printed

    Department of Respiratory Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam

14. Bas Robberts

    Radboud University Nijmegen · Radboud University Medical Center

    Affiliation as printed

    Department of Respiratory Medicine, Radboudumc, Nijmegen

15. Marijke Rutten

    Maastricht University Medical Centre · Maastricht University

    Affiliation as printed

    Department of Respiratory Medicine, Maastricht University Medical Center+, Maastricht

16. Roy T.M. Sprooten

    Maastricht University Medical Centre · Maastricht University

    Affiliation as printed

    Department of Respiratory Medicine, Maastricht University Medical Center+, Maastricht

17. Michiel Wagenaar

    Medisch Spectrum Twente

    Affiliation as printed

    Department of Respiratory Medicine, Medisch Spectrum Twente, Enschede

18. Frank W.J.M. Smeenk

    Catharina Ziekenhuis · Maastricht University

    Affiliation as printed

    Department of Medical Education, Catharina Hospital, Eindhoven, the Netherlands

    School of Health Professions Education (SHE), Maastricht University, Maastricht