Santa Maria Chloe, Sung Chi-Kwang, Lee Jennifer Y, Chhetri Dinesh K, Mendelsohn Abie H, Dewan Karuna
Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA.
Department of Otolaryngology-Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
OTO Open. 2021 Oct 29;5(4):2473974X211056530. doi: 10.1177/2473974X211056530. eCollection 2021 Oct-Dec.
To evaluate the benefits of simulation to teach flexible bronchoscopy.
A prospective cohort study to assess the bronchoscopic skills of residents in an otolaryngology training program using a commercially available bronchoscopy simulator.
Tertiary care otolaryngology residency program.
Thirty-two otolaryngology residents and 4 expert faculty across 2 academic institutions were assessed on 3 flexible bronchoscopy tasks: diagnostic bronchoscopy, foreign body removal, and tracheal lesion biopsy. Performance was evaluated with a modified version of the validated Bronchoscopy Skills and Tasks Assessment Tool. At 1 of the 2 academic institutions, an additional tool was implemented to evaluate the simulator.
There was a correlation between postgraduate training year and time taken to complete tasks, including bronchoscopy, foreign body extraction, and passing through the glottis ( < .001, = .04, and < .01, respectively). There was a significant difference between residents and faculty laryngologists for a range of skills and tasks, including percentage of time in middle lumen, contact with bronchial walls, inadvertent esophagus entry, and biopsy of healthy tissue ( < .001, = .003, < .001, and < .001). Additionally, increasing postgraduate level was correlated with a higher percentage of time in the center of the lumen and reduced time to task completion ( = .05 and < .001). Of 32 residents, 20 evaluated the simulator on its realism, with an average score of 4.1 of 5.
The commercially available flexible bronchoscopy simulator provides a valid assessment of bronchoscopic skill and is a useful tool for practicing bronchoscopy in a safe, controlled environment.
Individual cohort study.
评估模拟教学在柔性支气管镜检查培训中的益处。
一项前瞻性队列研究，使用市售支气管镜模拟器评估耳鼻喉科培训项目中住院医师的支气管镜操作技能。
三级医疗耳鼻喉科住院医师培训项目。
对两个学术机构的32名耳鼻喉科住院医师和4名专家教员进行了三项柔性支气管镜检查任务的评估：诊断性支气管镜检查、异物取出和气管病变活检。使用经过验证的支气管镜技能和任务评估工具的修改版对操作表现进行评估。在两个学术机构中的一个，还使用了另一种工具来评估模拟器。
研究生培训年份与完成任务所需时间之间存在相关性，包括支气管镜检查、异物取出和通过声门的时间（分别为<.001、=.04和<.01）。住院医师和喉科医生在一系列技能和任务方面存在显著差异，包括在中腔的时间百分比、与支气管壁的接触、意外进入食管以及对健康组织的活检（<.001、=.003、<.001和<.001）。此外，研究生水平的提高与在管腔中心的时间百分比增加和任务完成时间减少相关（=.05和<.001）。在32名住院医师中，20人对模拟器的逼真度进行了评估，平均得分为4.1（满分5分）。
市售的柔性支气管镜模拟器可对支气管镜操作技能进行有效评估，是在安全、可控环境中练习支气管镜检查的有用工具。
个体队列研究。
