Division of Pulmonary and Critical Care Medicine, Section of Interventional Pulmonology, School of Medicine, The Johns Hopkins University, Baltimore, MD.
University of Alabama at Birmingham, Birmingham, AL.
J Bronchology Interv Pulmonol. 2024 Sep 12;31(4). doi: 10.1097/LBR.0000000000000988. eCollection 2024 Oct 1.
Entry into the interventional pulmonary (IP) fellowship requires prerequisite training in pulmonary and critical care medicine (PCCM) fellowship in the United States. IP fellowship has become standardized, but the prerequisite training may be quite variable depending on the learner's exposure to IP during their PCCM fellowship. A survey study was conducted to identify potential foundational knowledge and/or skills gaps of new fellows entering IP fellowships. This may help both PCCM and IP fellowship directors to identify common knowledge gaps within PCCM training specific to IP.
Based on components of the ACGME's common program requirements for PCCM fellowships, a survey was developed and categorized into 5 domains: nonprocedural skills, didactic knowledge, diagnostic bronchoscopy, pleural procedures, and airway/percutaneous procedures. The survey was then sent to 42 IP fellowship directors after the content validity review and approval by the Association of Interventional Pulmonary Program Directors.
The survey response rate was 88.1% (37/42). The overall mean scores in all 5 domains were perceived as below competent (<3). The highest mean domain was nonprocedural skills, and the lowest was airway/percutaneous procedures. Within the domains, there were 4/ 30 topics that were considered competent with a score of ≥3 as competent or higher; bronchoscopy lavage (mean: 3.5/5, SD: 0.87), interpersonal skills (mean: 3.03/5, SD: 0.76), thoracentesis (mean: 3.14/5, SD: 0.89), and ultrasound for pleural effusion (mean: 3.19/5, SD: 0.84).
There are perceived gaps in PCCM training pertaining to IP fellowship readiness.
进入介入性肺病（IP） fellowship 需要在美国完成肺和重症监护医学（PCCM） fellowship 的先决条件培训。IP fellowship 已经标准化，但先决条件培训可能因学习者在 PCCM fellowship 期间接触 IP 的情况而有很大差异。进行了一项调查研究，以确定进入 IP fellowship 的新研究员可能存在的基础知识和/或技能差距。这可以帮助 PCCM 和 IP fellowship 主任确定 PCCM 培训中针对 IP 的常见知识差距。
根据 ACGME 对 PCCM fellowship 的共同计划要求的组成部分，开发了一项调查，并分为 5 个领域：非程序技能、理论知识、诊断性支气管镜检查、胸腔程序和气道/经皮程序。在内容有效性审查和介入性肺计划主任协会批准后，将调查发送给 42 名 IP fellowship 主任。
调查回复率为 88.1%（37/42）。所有 5 个领域的总体平均得分均低于称职（<3）。得分最高的领域是非程序技能，得分最低的是气道/经皮程序。在这些领域中，有 4/30 个主题被认为是称职的，得分≥3 表示称职或更高；支气管镜灌洗（平均：3.5/5，SD：0.87）、人际交往技巧（平均：3.03/5，SD：0.76）、胸腔穿刺术（平均：3.14/5，SD：0.89）和超声胸腔积液（平均：3.19/5，SD：0.84）。
在 PCCM 培训中，与 IP fellowship 准备相关的方面存在认知差距。
