Impact of structured curriculum with simulation on bronchoscopy.


Journal

Respirology (Carlton, Vic.)
ISSN: 1440-1843
Titre abrégé: Respirology
Pays: Australia
ID NLM: 9616368

Informations de publication

Date de publication:
06 2021
Historique:
revised: 16 02 2021
received: 30 09 2020
accepted: 17 03 2021
pubmed: 21 4 2021
medline: 1 10 2021
entrez: 20 4 2021
Statut: ppublish

Résumé

Simulation enhances a physician's competency in procedural skills by accelerating ascent of the learning curve. Training programmes are moving away from the Halstedian model of 'see one, do one, teach one', also referred as medical apprenticeship. We aimed to determine if a 3-month structured bronchoscopy curriculum that incorporated simulator training could improve bronchoscopy competency among pulmonary medicine trainees. We prospectively recruited trainees from hospitals with accredited pulmonary medicine programmes. Trainees from hospitals (A, B and C) were assigned to control group (CG) where they received training by traditional apprenticeship while trainees from hospital D were assigned to intervention group (IG) where they underwent 3-month structured curriculum that incorporated training with the bronchoscopy simulator. Two patient bronchoscopy procedures per trainee were recorded on video and scored independently by two expert bronchoscopists using the modified Bronchoscopy Skills and Tasks Assessment Tool (BSTAT) forms. A 25 multiple choice questions (MCQ) test was administered to all participants at the end of 3 months. Eighteen trainees participated; 10 in CG and eight in IG with equal female:male ratio. Competency assessed by modified BSTAT and MCQ tests was variable and not driven by volume as IG performed fewer patient bronchoscopies but demonstrated better BSTAT, airway anaesthesia and MCQ scores. Bronchoscopy simulator training was the only factor that correlated with better BSTAT (r = 0.80), MCQ (r = 0.85) and airway anaesthesia scores (r = 0.83), and accelerated the learning curve of IG trainees. An intensive 3-month structured bronchoscopy curriculum that incorporated simulator training led to improved cognitive and technical skill performance as compared with apprenticeship training.

Sections du résumé

BACKGROUND AND OBJECTIVE
Simulation enhances a physician's competency in procedural skills by accelerating ascent of the learning curve. Training programmes are moving away from the Halstedian model of 'see one, do one, teach one', also referred as medical apprenticeship. We aimed to determine if a 3-month structured bronchoscopy curriculum that incorporated simulator training could improve bronchoscopy competency among pulmonary medicine trainees.
METHODS
We prospectively recruited trainees from hospitals with accredited pulmonary medicine programmes. Trainees from hospitals (A, B and C) were assigned to control group (CG) where they received training by traditional apprenticeship while trainees from hospital D were assigned to intervention group (IG) where they underwent 3-month structured curriculum that incorporated training with the bronchoscopy simulator. Two patient bronchoscopy procedures per trainee were recorded on video and scored independently by two expert bronchoscopists using the modified Bronchoscopy Skills and Tasks Assessment Tool (BSTAT) forms. A 25 multiple choice questions (MCQ) test was administered to all participants at the end of 3 months.
RESULTS
Eighteen trainees participated; 10 in CG and eight in IG with equal female:male ratio. Competency assessed by modified BSTAT and MCQ tests was variable and not driven by volume as IG performed fewer patient bronchoscopies but demonstrated better BSTAT, airway anaesthesia and MCQ scores. Bronchoscopy simulator training was the only factor that correlated with better BSTAT (r = 0.80), MCQ (r = 0.85) and airway anaesthesia scores (r = 0.83), and accelerated the learning curve of IG trainees.
CONCLUSION
An intensive 3-month structured bronchoscopy curriculum that incorporated simulator training led to improved cognitive and technical skill performance as compared with apprenticeship training.

Identifiants

pubmed: 33876525
doi: 10.1111/resp.14054
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

597-603

Informations de copyright

© 2021 Asian Pacific Society of Respirology.

Références

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Auteurs

Wen Ting Siow (WT)

Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore.

Gan-Liang Tan (GL)

Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.

Chian-Min Loo (CM)

Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.

Kay-Leong Khoo (KL)

Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore.

Adrian Kee (A)

Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore.

Augustine Tee (A)

Department of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore.

Imran Bin Mohamed Noor (I)

Department of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore.

Noel Tay (N)

Division of Respiratory and Critical Care Medicine, Ng Teng Fong Hospital, Singapore.

Pyng Lee (P)

Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore.

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