Chest
Volume 118, Issue 3, September 2000, Pages 625-630
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Clinical Investigations
Techniques
Bronchoscopy Training: Current Fellows’ Experiences and Some Concerns for the Future

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Objectives

To determine current pulmonaryfellows’ perspectives about their bronchoscopy training.

Design

Survey of 59 pulmonary fellows selected by trainingprogram directors to represent their institutions.

Setting

“Hands-on” symposium at the CHEST 1998 annualmeeting, Toronto, Canada.

Results

Fellows reported amean (± SD) of 2.4 ± 0.7 years of training, estimated they hadperformed 77.7 ± 34 bronchoscopies per year, and had generally highestimates of their bronchoscopy proficiency and training. Proficiencyestimates correlated with number of procedures cited (r = 0.43,p = 0.001) or level of fellowship training (r = 0.40, p = 0.002).Proficiency ratings (r = 0.63, p = 0.0001) and procedure numbers(r = 0.45, p-0.0004) correlated with program quality ratings. Approaches to bronchoscopy instruction varied, and most often consistedof one-to-one instruction by faculty (92.5%), lecture-basedinstruction (74.6%), and case discussions (72.9%). Use ofbronchoscopy lectures (p = 0.008) or videos (p = 0.057) wereassociated with higher self-estimates of proficiency, whereas use oflectures (p = 0.002), a bronchoscopy text (p = 0.009), and one-on-one instruction (p = 0.05) were associated with more highlyranked programs. Major components of training varied among programs. Although most fellows had received instruction encompassed in basicbronchoscopy, fewer had experience with bronchoscopic intubation(71.2%), transbronchial needle aspiration (72.9%), quantitativebacterial culture (64.4%), stent placement (27.1%), laserphotocoagulation (25.4%), or cryotherapy (6.8%). Components ofbronchoscopy experiences correlated with fellows’ estimates ofbronchoscopy proficiency and program quality.

Conclusions

Approaches to bronchoscopy instruction and thecomponents of bronchoscopy experiences vary considerably amonginstitutions and are associated with pulmonary fellows’ perceptions ofbronchoscopy proficiency and training program quality. Definition of anoptimum bronchoscopy curriculum remainsnecessary.

Key words

bronchoscopy training
pulmonary fellowship training

Abbreviations

TBNA
transbronchial needleaspiration

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