Learning Gain and Skill Retention Following Unstructured Bronchoscopy Simulation in a Low-fidelity Airway Model. Issue 4 (October 2020)

• Record Type: Journal Article
• Authors: Feng, David B.; Yong, Yi Heng; Byrnes, Timothy; Gorelik, Alex; Colt, Henri; Irving, Louis B.; Steinfort, Daniel
• Is Part Of: Journal of bronchology & interventional pulmonology. Volume 27:Issue 4(2020)
• Publication Date: 2020-10
• Subjects: bronchoscopy -- teaching -- low-fidelity simulator; Bronchoscopy -- Periodicals; Lungs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Lung Diseases -- surgery -- Periodicals; Diagnostic Techniques, Respiratory System -- Periodicals; Bronchi; Bronchoscopy; Lungs -- Diseases; Periodicals; 616.23
• DOI: 10.1097/LBR.0000000000000664
• Languages: English
• ISSNs: 1944-6586

Abstract

Abstract : Background: Simulation is invaluable for bronchoscopy training. Studies report improved procedure time, dexterity/technique, and trainee satisfaction supported by low-fidelity and high-fidelity simulators in structured-training programs. We sought to determine (1) Learning-gain in bronchoscopic dexterity after a single 45-minute unstructured exposure using a low-fidelity simulator. (2) Whether acquired skills are maintained 8 weeks later, during which trainees receive no interim exposure to simulation or clinical bronchoscopy. Methods: Using a low-fidelity model, medical students were assessed for bronchoscopicdexterity before and after an unstructured, self-directed 45-minute simulation. Bronchoscopic dexterity was assessed according to: (1) Ability to enter a target-bronchus within a specified time. (2) The modified Bronchoscopy Skills and Tasks Assessment Tool (mBSTAT). Scores were compared at baseline, postsimulation, and 8 weeks postsimulation. Individual domains of the mBSTAT were compared with identify specific skills demonstrating more significant deterioration. Results: Twenty-eight medical students completed the initial-simulation session. Fifteen returned at 8 weeks. Statistically significant improvement in bronchoscopic-skills was observed immediately following the simulation session (mBSTAT scores 3.7±1.2 pretest vs. 7.0±0.9 posttest, P <0.001). mBSTAT scores had deteriorated significantly at 8 weeks (5.7±1.8, P =0.03) but remained superior to baseline scores ( P =0.002). Of the 4 domains assessed, only Precision did not demonstrate any change between post-test and review assessments ( P =0.14). All other domains demonstrated trends towards significant deterioration between posttest and review. Conclusion: A single 45-minute unstructured bronchoscopy simulation session resulted in significant improvement in bronchoscopic dexterity. Significant decay in bronchoscopic dexterity is observed, suggesting repeat simulation may be valuable following periods without bronchoscopy exposure. Abstract : Supplemental Digital Content is available in the text.