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. 2021 Jun;26(6):597-603.
doi: 10.1111/resp.14054. Epub 2021 Apr 19.

Impact of structured curriculum with simulation on bronchoscopy

Wen Ting Siow  1 , Gan-Liang Tan  2 , Chian-Min Loo  2 , Kay-Leong Khoo  1 , Adrian Kee  1 , Augustine Tee  3 , Imran Bin Mohamed Noor  3 , Noel Tay  4 , Pyng Lee  1
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Free article

Impact of structured curriculum with simulation on bronchoscopy

Wen Ting Siow et al. Respirology. 2021 Jun.
Free article

Abstract

Background and objective: Simulation enhances a physician's competency in procedural skills by accelerating ascent of the learning curve. Training programmes are moving away from the Halstedian model of 'see one, do one, teach one', also referred as medical apprenticeship. We aimed to determine if a 3-month structured bronchoscopy curriculum that incorporated simulator training could improve bronchoscopy competency among pulmonary medicine trainees.

Methods: We prospectively recruited trainees from hospitals with accredited pulmonary medicine programmes. Trainees from hospitals (A, B and C) were assigned to control group (CG) where they received training by traditional apprenticeship while trainees from hospital D were assigned to intervention group (IG) where they underwent 3-month structured curriculum that incorporated training with the bronchoscopy simulator. Two patient bronchoscopy procedures per trainee were recorded on video and scored independently by two expert bronchoscopists using the modified Bronchoscopy Skills and Tasks Assessment Tool (BSTAT) forms. A 25 multiple choice questions (MCQ) test was administered to all participants at the end of 3 months.

Results: Eighteen trainees participated; 10 in CG and eight in IG with equal female:male ratio. Competency assessed by modified BSTAT and MCQ tests was variable and not driven by volume as IG performed fewer patient bronchoscopies but demonstrated better BSTAT, airway anaesthesia and MCQ scores. Bronchoscopy simulator training was the only factor that correlated with better BSTAT (r = 0.80), MCQ (r = 0.85) and airway anaesthesia scores (r = 0.83), and accelerated the learning curve of IG trainees.

Conclusion: An intensive 3-month structured bronchoscopy curriculum that incorporated simulator training led to improved cognitive and technical skill performance as compared with apprenticeship training.

Keywords: bronchoscopy; competency; education; procedure; simulation-based training.

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References

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