A Pilot Program Assessing Bronchoscopy Training and Program Initiation in a Low-income Country.
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:
01 Apr 2021
01 Apr 2021
Historique:
received:
25
06
2020
accepted:
10
09
2020
pubmed:
27
10
2020
medline:
9
11
2021
entrez:
26
10
2020
Statut:
ppublish
Résumé
Flexible bronchoscopy is an essential procedure for the evaluation and management of the pulmonary disease. However, this technology and related training is not available in many low-middle income countries (LMICs). We conducted a pilot training program for flexible bronchoscopy in Uganda. A multimodal curriculum was developed with pulmonologists from Uganda and the United States. The training included an online distance learning management system for video content, simulation, just-in-time training, and deliberate practice via clinical proctoring. Procedural standards and a de novo bronchoscopy suite were concurrently developed. Competency was assessed using the Bronchoscopic Skills and Tasks Assessment Tool written examination and the Ontario Bronchoscopy Assessment Tool. We trained 3 pulmonary physicians with no prior experience in flexible bronchoscopy. Three bronchoscopies with bronchoalveolar lavage were performed during the training and an additional 11 cases were performed posttraining. All 3 Ugandan physicians had an increase in their written Bronchoscopic Skills and Tasks Assessment Tool and Ontario Bronchoscopy Assessment Tool in the competent range (P<0.05). All bronchoscopies were successfully completed, adequate samples were obtained, and there were no procedure-related complications. Bronchoscopy implementation in LMICs is feasible, but requires competency-based training. Further studies are needed to validate this curriculum in LMICs, including the use of this type of curriculum for more complicated bronchoscopic procedures.
Sections du résumé
BACKGROUND
BACKGROUND
Flexible bronchoscopy is an essential procedure for the evaluation and management of the pulmonary disease. However, this technology and related training is not available in many low-middle income countries (LMICs). We conducted a pilot training program for flexible bronchoscopy in Uganda.
METHODS
METHODS
A multimodal curriculum was developed with pulmonologists from Uganda and the United States. The training included an online distance learning management system for video content, simulation, just-in-time training, and deliberate practice via clinical proctoring. Procedural standards and a de novo bronchoscopy suite were concurrently developed. Competency was assessed using the Bronchoscopic Skills and Tasks Assessment Tool written examination and the Ontario Bronchoscopy Assessment Tool.
RESULTS
RESULTS
We trained 3 pulmonary physicians with no prior experience in flexible bronchoscopy. Three bronchoscopies with bronchoalveolar lavage were performed during the training and an additional 11 cases were performed posttraining. All 3 Ugandan physicians had an increase in their written Bronchoscopic Skills and Tasks Assessment Tool and Ontario Bronchoscopy Assessment Tool in the competent range (P<0.05). All bronchoscopies were successfully completed, adequate samples were obtained, and there were no procedure-related complications.
CONCLUSION
CONCLUSIONS
Bronchoscopy implementation in LMICs is feasible, but requires competency-based training. Further studies are needed to validate this curriculum in LMICs, including the use of this type of curriculum for more complicated bronchoscopic procedures.
Identifiants
pubmed: 33105417
pii: 01436970-202104000-00009
doi: 10.1097/LBR.0000000000000721
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
138-142Informations de copyright
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure: H.J.L. has received educational grants and/or consulting fees from Merit Medical, Cook Medical, Veran Medical, and Veracyte. A.C.A. has received consulting fees from Cook Medical and Olympus. L.Y. has received consulting fees from Olympus. For the remaining authors there is no conflict of interest or other disclosures.
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