Learning Electromagnetic Navigational Bronchoscopy and Percutaneous Transthoracic Needle Biopsy (LEAP): A Pilot Study.


Journal

Journal of bronchology & interventional pulmonology
ISSN: 1948-8270
Titre abrégé: J Bronchology Interv Pulmonol
Pays: United States
ID NLM: 101496866

Informations de publication

Date de publication:
Jan 2019
Historique:
pubmed: 14 12 2018
medline: 26 3 2019
entrez: 14 12 2018
Statut: ppublish

Résumé

Prior studies in pulmonology have examined the validity of procedural training tools, however, translation of simulation skill acquisition into real world competency remains understudied. We examine an assessment process with a simulation training course for electromagnetic navigational (EMN) bronchoscopy and percutaneous transthoracic needle aspiration (PTTNA). A cohort study was conducted by subjects using EMN bronchoscopy and PTTNA. A procedural assessment tool was developed to measure basic competency for EMN bronchoscopy and PTTNA at 3 different time points: first simulation case, final simulation case upon reaching a competent score, and at their first live case. The assessment tool was divided into 4 domains (total score, 4 to 16; competency ≥12) with each domain requiring a passing score (1 to 4; competency ≥3.0). Complication and procedural time were collected during their first live case. Twenty-two serial procedures (12 EMN bronchoscopies, 10 EMN PTTNA) were observed by 14 subjects. The mean first simulation score for EMN bronchoscopy (4.66±0.89) improved after cadaver simulation (12.67±0.89, median 3 simulations attempts). The subjects' mean score for their first live case was 13.0±0.85 (self-reported score 12.5±1.07). For EMN PTTNA, the mean first simulation score (4.3±2.40) improved after cadaver simulation (12.6±1.51, median 3 simulation attempts). The subjects' mean score for their first live PTTNA case was 12.5±2.87 (self-reported score 12.1±1.05). There was only 1 minor complication. Learning EMN bronchoscopy/PTTNA is feasible using a structured simulation course with an assessment tool.

Sections du résumé

BACKGROUND BACKGROUND
Prior studies in pulmonology have examined the validity of procedural training tools, however, translation of simulation skill acquisition into real world competency remains understudied. We examine an assessment process with a simulation training course for electromagnetic navigational (EMN) bronchoscopy and percutaneous transthoracic needle aspiration (PTTNA).
METHODS METHODS
A cohort study was conducted by subjects using EMN bronchoscopy and PTTNA. A procedural assessment tool was developed to measure basic competency for EMN bronchoscopy and PTTNA at 3 different time points: first simulation case, final simulation case upon reaching a competent score, and at their first live case. The assessment tool was divided into 4 domains (total score, 4 to 16; competency ≥12) with each domain requiring a passing score (1 to 4; competency ≥3.0). Complication and procedural time were collected during their first live case.
RESULTS RESULTS
Twenty-two serial procedures (12 EMN bronchoscopies, 10 EMN PTTNA) were observed by 14 subjects. The mean first simulation score for EMN bronchoscopy (4.66±0.89) improved after cadaver simulation (12.67±0.89, median 3 simulations attempts). The subjects' mean score for their first live case was 13.0±0.85 (self-reported score 12.5±1.07). For EMN PTTNA, the mean first simulation score (4.3±2.40) improved after cadaver simulation (12.6±1.51, median 3 simulation attempts). The subjects' mean score for their first live PTTNA case was 12.5±2.87 (self-reported score 12.1±1.05). There was only 1 minor complication.
CONCLUSION CONCLUSIONS
Learning EMN bronchoscopy/PTTNA is feasible using a structured simulation course with an assessment tool.

Identifiants

pubmed: 30543552
doi: 10.1097/LBR.0000000000000520
pmc: PMC6298825
mid: NIHMS963166
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

55-61

Subventions

Organisme : NHLBI NIH HHS
ID : T32 HL007534
Pays : United States

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Auteurs

Hans J Lee (HJ)

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

Andrew D Lerner (AD)

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

Briana Coleman (B)

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

Roy Semaan (R)

Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.

Christopher Mallow (C)

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

Sixto Arias (S)

Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Miami, Miami, FL.

Ben Salwen (B)

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

David Feller-Kopman (D)

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

Lonny Yarmus (L)

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

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Classifications MeSH