Gupta Samiksha, Ghiathi Christopher, DiBardino David, Josan Enambir S, Salguero Bertin D, Chaddha Udit, Wayne Max T, De Cardenas Jose, Matta Maroun, Young Benjamin, Dunatchik Andrew, Di Felice Christopher, Avasarala Sameer K
Division of Pulmonary, Critical Care, and Sleep Medicine, University Hospitals, and.
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania.
ATS Sch. 2025 Jun;6(2):179-190. doi: 10.34197/ats-scholar.2024-0079OC. Epub 2025 Feb 18.
Currently, there is significant variability in bronchoscopy training across pulmonary and critical care medicine (PCCM) programs nationwide, including procedural volume and exposure to simulation training. Despite the increased number of interventional pulmonology (IP) fellowship programs in the United States, their direct educational impact on PCCM fellows' bronchoscopy training is unknown. To identify and quantify the differences in flexible bronchoscopy competency among PCCM fellows from institutes with IP fellowships compared with those without IP fellowships. This multicenter, prospective cohort study included the assessment of PCCM fellows from two groups, using the Ontario Bronchoscopy Assessment Tool (OBAT): ) PCCM fellowships with a coexistent IP fellowship program and ) PCCM fellowships without an IP fellowship program. The primary outcome was the difference in mean score between the two groups; secondary outcomes included the mean OBAT score of first, second, and third-year (or above) fellows in the two groups and the percentage of fellows in the two groups who were capable of independently performing the procedure. There were five participating training sites: two with IP fellowships and three without IP fellowships. A total of 50 OBAT assessments were performed (25 in each group) by the supervising attending physician. The mean OBAT score was 3.58 ± 0.65 in the IP group compared with 4.33 ± 0.61 in the non-IP group ( < 0.001). The mean (standard deviation) OBAT scores of the first, second, and third-year (or above) fellows were 3.36 (0.5), 3.48 (0.4), and 4.53 (0.5) in the IP group and 3.75 (0.8), 4.25 (0.5), and 4.7 (0.3) in the non-IP group, respectively. The mean OBAT score was directly proportional to the number of procedures done by the fellows. There was a statistically significant difference in the mean OBAT scores between the two groups; the mean OBAT score was higher in the non-IP fellowship group. Although a more comprehensive study is needed to fully account for the various factors that can impact bronchoscopy training, this study highlights a key difference in basic bronchoscopy training among PCCM trainees. The presence of IP fellowship is one of the many factors that can affect the basic bronchoscopy skills of PCCM fellows.
目前，美国全国范围内，肺科和重症医学（PCCM）项目的支气管镜检查培训存在很大差异，包括操作量和模拟培训的接触程度。尽管美国介入肺科学（IP） fellowship项目的数量有所增加，但其对PCCM学员支气管镜检查培训的直接教育影响尚不清楚。目的是确定并量化有IP fellowship项目的机构与没有IP fellowship项目的机构中，PCCM学员在柔性支气管镜检查能力方面的差异。这项多中心前瞻性队列研究使用安大略支气管镜检查评估工具（OBAT）对两组PCCM学员进行了评估：（1）同时设有IP fellowship项目的PCCM fellowship项目；（2）没有IP fellowship项目的PCCM fellowship项目。主要结果是两组之间的平均分数差异；次要结果包括两组中第一年、第二年和第三年（及以上）学员的平均OBAT分数，以及两组中能够独立进行该操作的学员百分比。共有五个参与培训地点：两个设有IP fellowship项目，三个没有IP fellowship项目。监督主治医师共进行了50次OBAT评估（每组25次）。IP组的平均OBAT分数为3.58±0.65，而非IP组为4.33±0.61（P<0.001）。IP组第一年、第二年和第三年（及以上）学员的平均（标准差）OBAT分数分别为3.36（0.5）、3.48（0.4）和4.53（0.5），非IP组分别为3.75（0.8）、4.25（0.5）和4.7（0.3）。平均OBAT分数与学员所做操作的数量成正比。两组之间的平均OBAT分数存在统计学显著差异；非IP fellowship组的平均OBAT分数更高。尽管需要进行更全面的研究以充分考虑可能影响支气管镜检查培训的各种因素，但本研究突出了PCCM学员在基础支气管镜检查培训方面的一个关键差异。IP fellowship的存在是影响PCCM学员基础支气管镜检查技能的众多因素之一。
