MedEdPORTAL (Dec 2015)
Flexible Bronchoscopy Curriculum
Abstract
Abstract Introduction Bronchoscopy is performed almost exclusively by subspecialists; therefore, novice bronchoscopists may find themselves with the responsibility of performing a bronchoscopy without ever having previously observed one. Novice bronchoscopists are always supervised, but the demands of clinical care may mean that there is little time available for teaching bronchoscopy prior to the novice performing his/her first procedure. This situation can result in anxiety on the part of the novice bronchoscopist, as well in the potential for errors. This is a multimodule course designed to introduce novice bronchoscopists (physicians, surgeons, and advanced practice providers) to flexible fiber-optic bronchoscopy. Methods Learners view a series of online video modules and are examined on their knowledge of flexible bronchoscopy in a pre− and posttest assessment. Each module consists of a video that includes written content, diagrams, simulated cases, and clinical examples where appropriate. They are designed to be complementary and build on one another sequentially but can also be used individually for easy review. The modules were implemented at the beginning of the 2014-2015 academic year at the University of Washington. We had 100% participation from the pulmonary critical care, medical critical care, and anesthesia critical care fellows, all of whom completed the modules and tests prior to starting their fellowships on July 1. Results The results of the pre− and posttests demonstrate that our participating trainees did learn from the modules. They reported that the posttest was harder than the pretest, and so we plan to switch some of the questions and to reassess the level of difficulty with some of our senior fellows before administering the questions to our next group of trainees. We have made every effort to include questions that test an appropriate range of knowledge applicable to all subspecialty participants and based upon widely recognized data or expert consensus. However, instructors may choose to modify these assessments based on the scope of practice at their own institutions. Discussion In the future, we plan to improve the current modules, distribute them to a wider group of trainees, examine their use for just-in-time learning, and measure knowledge retention in our trainees. We also plan to create additional modules to include bronchoscopic interventions such as transbronchial lung biopsy, transbronchial needle aspiration, endobronchial biopsy, and the use of cytology and protected specimen brushes.
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