Introduction Bronchoscopy simulation is becoming increasingly used as a tool to improve the confidence and knowledge of trainees, with the intention of increasing the speed of skill acquisition. Although this training has been shown to be effective, little research has been conducted into whether retention of skills occurs. Health Education Yorkshire and The Humber (HEYH) previously designed a mandatory programme to support the education of trainees and this has been extended to involve Anaesthetic trainees who often perform bronchoscopy.

Methods 8 Respiratory, 8 Anaesthetic and 8 bronchoscopy naive trainees underwent the simulation course. They participated in an assessment two months later. All trainees had access to the simulator to practice in the two-month period. Pre/post course and post assessment Likert scale questionnaires were carried out to assess confidence. Dexterity was assessed with data generated from the Simbionix Simulator including: final navigation scores, bronchial segments identified correctly and number wall hits in the large airways. Knowledge testing was carried out using a preparing the patient metal algorithm taught during the course. The data generated was recorded on an assessment proforma entitled the Basic Bronchoscopy Simulation Assessment Tool (BBSAT).

Results Statistically significant confidence levels were found in 9 domains in all trainees after the course. Confidence levels fell significantly after assessment in the majority of domains (Table1). Dexterity was retained at assessment, but a small fall in anatomical knowledge was demonstrated in Anaesthetic and Respiratory trainees. MCQ knowledge also showed a general decrease at assessment. The average BBSAT score was 67.2/72 (93%) indicating that all trainees had retained the basic level of skills required to perform bronchoscopy in a simulated environment.

Conclusion Overall, skills and knowledge are retained to a level required to perform bronchoscopy in a simulated environment, however confidence of trainees is significantly affected at assessment two months later. We propose that trainees are provided with mandatory bronchoscopy simulation training accompanied by assessment to ensure that skills are retained. We believe that basic bronchoscopy should be mastered before diagnostic bronchoscopy is broached; hence the use of a mastery assessment similar to the BBSAT may helpful in guiding simulation-based assessment.

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Figure 1.

Trainee improvement in confidence after attending the Medical Thoracoscopy and IPC insertion