title: Bronchoscopy simulator effectively prepares junior residents to competently perform basic clinical bronchoscopy.
abstract: BACKGROUND
  Teaching procedural skills in a clinical setting is becoming increasingly difficult. Simulators can provide safe and inexpensive skills training. This randomized study was conducted to evaluate the effectiveness of a bronchoscopy simulator in teaching clinical bronchoscopy.
  
  
  METHODS
  Three groups of surgical residents were evaluated while performing an intraoperative flexible bronchoscopy. First year (PGY1) residents were randomly assigned to perform bronchoscopy either with (n = 5) or without (n = 5) preprocedural bronchoscopic simulator training (PreOp flexible bronchoscopic simulator, Immersion Medical, Gaithersburg, MD). Residents PGY2 to 3 (n = 3) with prior bronchoscopic experience (> or = 10 bronchoscopies) underwent evaluation without simulator training. Subjects were required to complete a systematic airway examination through a laryngeal mask airway with patients under general anesthesia. Evaluation criteria included procedure time, number of verbal and physical interventions by evaluator, and a rating of exam thoroughness, proficiency, and confidence.
  
  
  RESULTS
  The PGY1 subjects who trained on the simulator required significantly fewer verbal (6.2 +/- 1.6 vs 3.2 +/- 0.8) and physical (1.6 +/- 0.2 vs 0.2 +/- 0.4) cues and performed more systematic examinations (2.6 +/- 0.5 vs 4.4 +/- 0.9 on scale 1 to 5) than those who did not use the trainer. The skill level of PGY1 subjects who worked with the simulator was similar to that of PGY2 to 3 residents experienced in bronchoscopy. Procedural times were not different between groups as the evaluator maintained the pace of the examination using verbal and physical assistance.
  
  
  CONCLUSIONS
  One hour of training with the bronchoscopic simulator effectively taught residents basic bronchoscopy and familiarity with airway anatomy. Residents using the trainer performed first-time bronchoscopy nearly as competently as residents experienced with bronchoscopy.
authors.affiliation: Division of Cardiothoracic Surgery, Northwestern Memorial Hospital, Chicago, Illinois, USA. mblum@nmh.org
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Blum
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Powers
authors.forename: Sudhir
authors.initials: S
authors.lastname: Sundaresan
mesh_terms: D001296:Audiovisual Aids; D001999:Bronchoscopy; D003198:Computer Simulation; D004867:Equipment Design; D013502:General Surgery / Q000193:education; D006801:Humans; D007430:Intraoperative Care; D016037:Single-Blind Method; D011795:Surveys and Questionnaires