Experience of an advanced multidisciplinary simulation course and literature review: bronchoscopy and beyond
Abstract
Simulation based training has demonstrated several advantages over the apprenticeship model with provision of a safe learning environment, accelerated skill acquisition and transfer of skills to clinical domains. Specialties including cardiothoracic surgery, respiratory medicine and critical care have adopted simulation based training to teach a variety of postgraduate procedures. In the field of interventional pulmonology strong evidence exists to support the use of simulation based training to teach basic bronchoscopic skills, however there is a paucity of literature with regards to the role of simulation in training for endobronchial ultrasound and endobronchial valves. The authors describe their experience of conducting an advanced simulation based course teaching the principles of flexible and rigid bronchoscopy, endobronchial ultrasound and endobronchial valves. The one day course combines both high and low fidelity simulators; BRONCH MentorTM Simbionix and Bronchoboy Trainer used with a real flexible bronchoscope. In total 28 delegates from medicine, cardiothoracic surgery and anaesthesia, completed the course between 2014 and 2019. All delegates completed a 5-point Likert scale based questionnaire prior to and following the course to self assess confidence across the domains taught. Pre-course questionnaires demonstrated areas of least confidence as operation, preparation and performance of rigid bronchoscopy, planning an endobronchial valve and performance of endobronchial ultrasound. Post course questionnaires demonstrated a statistically significant increase in confidence scores across all four procedures (p<0.001). Limitations upon training due to restrictions on trainee working hours, patient safety and the COVID-19 pandemic have presented challenges to training in interventional pulmonology. Simulation based courses may have a role in mitigating these challenges and enhance postgraduate training.
