Background Reduced exposure to bronchoscopyis a key issue for respiratory trainees with effect on their confidence in undertaking the procedure and thus patient safety. Studies have shown that simulation improves confidence in bronchoscopy skills but do not explore the most optimal teaching methods.
Aim To assess two different methods of delivering bronchoscopy simulation training
Methods Two half day simulation bronchoscopy courses were designed independently within the Yorkshire and Humber Deanery. Course 1 concentrated on providing a knowledge based training consisting of a didactic lecture followed by equal time spent on a Symbionixsimulator and on the BTS e-learning hub website. Course 2 provided pre-course material in the form of BTS guidelines and bronchoscopy procedure pocketbook. The course focused on hands-on simulation training using a bronchoscopy manikin and the Symbionix simulator. All candidates completed pre and post course Likert scale questionnaires in six areas relating to participant knowledge and confidence in using a bronchoscope.
Results Overall 30 trainees; 15 in each course were evaluated. Candidates had performed between 0 to >300 previous bronchoscopies and were from across the SpR years. Both courses delivered significant improvement in confidence scores in all of the six areas assessed. The greatest improvement was found in confidence levels in technical ability (see table 1). Course 1 candidates showed a greater confidence improvement in factual skills (such as knowledge of contra-indications of the procedure and anatomy). Course 2 demonstrated that 93% of candidates agreed that the simulator helped to improve technical ability in contrast to 100% with manikin exposure. 100% of candidates found the pocketbook was a useful adjuvant to the course with 93% agreeing that they would find this useful to complement their training.
Conclusions A combined and standardised bronchoscopy simulation course incorporating lectures and pre-course materials but focusing on hands on experience on both a manikin and a simulator is therefore considered to provide greatest educational benefit. This course is now active in Yorkshire and the Humber and is to be mandated for all new trainees to the programme. Each SpR will also be re-assessed after a 3-month period incorporating a competency-based assessment approach.
Authors 1 and 2 are first authors
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