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Ann Thorac Surg 2004;78:287-291
© 2004 The Society of Thoracic Surgeons

Original article: general thoracic

Bronchoscopy simulator effectively prepares junior residents to competently perform basic clinical bronchoscopy

Matthew G. Blum, MDa*, Thomas W. Powers, BAb, Sudhir Sundaresan, MDc

a Division of Cardiothoracic Surgery, Chicago, Illinois, USA
b Northwestern Institute for Minimally Invasive Surgery and Technology, Chicago, Illinois, USA
c Department of Surgery, Northwestern Memorial Hospital, Chicago, Illinois, USA

Accepted for publication November 25, 2003.

* Address reprint requests to Dr Blum, 201 E Huron St, Chicago, IL 60611, USA
e-mail: mblum{at}nmh.org

Presented at the Thirty-ninth Annual Meeting of The Society of Thoracic Surgeons, San Diego, CA, Jan 31–Feb 2, 2003.

BACKGROUND: Teaching procedural skills in a clinical setting is becoming increasingly difficult. Simulators can provide safe and inexpensive skills training. This randomized study was conducted to evaluate the effectiveness of a bronchoscopy simulator in teaching clinical bronchoscopy.

METHODS: Three groups of surgical residents were evaluated while performing an intraoperative flexible bronchoscopy. First year (PGY1) residents were randomly assigned to perform bronchoscopy either with (n = 5) or without (n = 5) preprocedural bronchoscopic simulator training (PreOp flexible bronchoscopic simulator, Immersion Medical, Gaithersburg, MD). Residents PGY2 to 3 (n = 3) with prior bronchoscopic experience (≥ 10 bronchoscopies) underwent evaluation without simulator training. Subjects were required to complete a systematic airway examination through a laryngeal mask airway with patients under general anesthesia. Evaluation criteria included procedure time, number of verbal and physical interventions by evaluator, and a rating of exam thoroughness, proficiency, and confidence.

RESULTS: The PGY1 subjects who trained on the simulator required significantly fewer verbal (6.2 ± 1.6 vs 3.2 ± 0.8) and physical (1.6 ± 0.2 vs 0.2 ± 0.4) cues and performed more systematic examinations (2.6 ± 0.5 vs 4.4 ± 0.9 on scale 1 to 5) than those who did not use the trainer. The skill level of PGY1 subjects who worked with the simulator was similar to that of PGY2 to 3 residents experienced in bronchoscopy. Procedural times were not different between groups as the evaluator maintained the pace of the examination using verbal and physical assistance.

CONCLUSIONS: One hour of training with the bronchoscopic simulator effectively taught residents basic bronchoscopy and familiarity with airway anatomy. Residents using the trainer performed first-time bronchoscopy nearly as competently as residents experienced with bronchoscopy.




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