Introduction Medical thoracoscopy (MT) and indwelling pleural catheter (IPC) insertion are becoming increasingly utilised for the purposes of diagnostic and therapeutic intervention in pleural disease. We are at the cusp of a paradigm shift towards the expansion of hospital services within Respiratory departments nationally, to accommodate the ever increasing demand of advances in medical treatment. Few courses are available that train respiratory doctors nationally. Health Education Yorkshire and The Humber have designed a novel simulation course to teach trainees the skills of MT and IPC insertion.
Methods A respiratory simulation team involving three consultants and a registrar used an approach similar to that described by Tjiam et al. 2012 using a cognitive task analysis (CTA) and the four component instructural design (4C/ID) as the basis of the course. The blueprint was created which broke down the tasks involved. The course consisted of four lectures and a demonstration followed by four stations including medical thoracoscopy; trocar and chest drain insertion; IPC insertion and a multiple choice questionnaire (MCQ). Peer review of the lectures and also the MCQ was also carried out. All consultants from specialist lung cancer services across the region were invited to be faculty on the course. Pre and post course Likert scale questionnaires were used to assess confidence levels.
Results Statistically significant improvements in confidence levels were achieved in all 8 domains, particularly in technical ability in handling the thoracoscopy equipment and IPC insertion (figure 1). 100% of consultants agreed that the course was mapped to the respiratory curriculum requirements and that the content was appropriate for ST5 trainees. 100% of consultant faculty also agreed that the course structure was adequate; the lectures were delivered at an appropriate level and were happy for the course to be run on a yearly basis. Candidate feedback was positive and indicated that the course would be a useful addition to the training programme.
Conclusion With medical advancements and expansion of Lung Cancer Services nationwide, respiratory doctors are increasingly needed to master MT and IPC insertion skills. Intra-deanery training should be provided for trainees to ensure sustainability of services.