title: Assessment and learning curve evaluation of endobronchial ultrasound skills following simulation and clinical training.
abstract: OBJECTIVE
  Endobronchial ultrasound is a revolutionary diagnostic pulmonary procedure. The use of a computer endobronchial ultrasound simulator could improve trainee procedural skills before attempting to perform procedures on patients. This study aims to compare endobronchial ultrasound performance following training with simulation versus conventional training using patients.
  
  
  METHODS
  A prospective study of pulmonary medicine and thoracic surgery trainees. Two cohorts of trainees were evaluated using simulated cases with performance metrics measured by the simulator. Group 1 received endobronchial ultrasound training by performing 15 cases on an endobronchial ultrasound simulator (n=4). Group 2 received endobronchial ultrasound training by doing 15-25 cases on patients (n=9).
  
  
  RESULTS
  Total procedure time was significantly shorter in group 1 than group 2 (15.15 (±1.34) vs 20.00 (±3.25) min, P<0.05). The percentage of lymph nodes successfully identified was significantly better in group 1 than group 2 (89.8 (±5.4) vs 68.1 (±5.2), P < 0.05). There was no difference between group 1 and group 2 in the percentage of successful biopsies (100.0 (±0.0) vs 90.4 (±11.5), P=0.13). The learning curves for simulation trained fellows did not show an obvious plateau after 19 simulated cases.
  
  
  CONCLUSIONS
  Using an endobronchial ultrasound simulator leads to more rapid acquisition of skill in endobronchial ultrasound compared with conventional training methods, as assessed by an endobronchial ultrasound simulator. Endobronchial ultrasound simulators show promise for training with the advantage of minimizing the burden of procedural learning on patients.
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada. davestather@yahoo.ca
authors.forename: David R
authors.initials: DR
authors.lastname: Stather
authors.forename: Paul
authors.initials: P
authors.lastname: Maceachern
authors.forename: Karen
authors.initials: K
authors.lastname: Rimmer
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Hergott
authors.forename: Alain
authors.initials: A
authors.lastname: Tremblay
mesh_terms: D000328:Adult; D001980:Bronchi / Q000000981:diagnostic imaging*; D001999:Bronchoscopy / Q000193:education* / Q000379:methods; D002983:Clinical Competence; D003198:Computer Simulation; D005260:Female; D006801:Humans; D059032:Learning Curve; D008297:Male; D015272:Pulmonary Medicine / Q000193:education*; D019616:Thoracic Surgical Procedures / Q000193:education*; D014463:Ultrasonography