title: Evaluation of clinical endobronchial ultrasound skills following clinical versus simulation training.
abstract: OBJECTIVE
  Endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA) is a pulmonary procedure that can be challenging to learn. This study aims to compare trainee EBUS-TBNA performance during clinical procedures, following training with a computer EBUS-TBNA simulator versus conventional clinical EBUS-TBNA training.
  
  
  METHODS
  A prospective study of pulmonary trainees performing EBUS-TBNA procedures on patients with suspected lung cancer and mediastinal adenopathy. Two cohorts of trainees were each evaluated while performing EBUS-TBNA on two patients. Group 1 received training by performing 15 cases on an EBUS-TBNA simulator (n = 4) and had never performed a clinical EBUS-TBNA procedure. Group 2 received training by doing 15-25 EBUS-TBNA procedures on patients (n = 4).
  
  
  RESULTS
  There was no significant difference in the primary outcome measure of total EBUS-TBNA procedure time/number of successful aspirates between Groups 1 and 2 (3.95 (±0.93) vs 3.64 (±0.89), P = 0.51). Total learner EBUS-TBNA procedure time in minutes (23.67 (±5.58) vs 21.81 (±5.36), P = 0.17) and percentage of successful aspirates (93.3% (±5.8%) vs 86.3% (±6.7%), P = 0.12) were not significantly different between Group 1 and Group 2. The only significant difference found between Group 1 and Group 2 was time to intubation in minutes (0.99 (±0.46) vs 0.50 (±0.42), P = 0.04).
  
  
  CONCLUSIONS
  EBUS-TBNA simulator use leads to rapid acquisition of clinical EBUS-TBNA skills comparable with that obtained with conventional training methods using practice on patients, suggesting that skills learned using an EBUS-TBNA simulator are transferable to clinical EBUS-TBNA performance. EBUS-TBNA simulators show promise for training, potentially 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: Alex
authors.initials: A
authors.lastname: Chee
authors.forename: Elaine
authors.initials: E
authors.lastname: Dumoulin
authors.forename: Alain
authors.initials: A
authors.lastname: Tremblay
mesh_terms: D000328:Adult; D001707:Biopsy, Needle / Q000592:standards*; D001999:Bronchoscopy / Q000193:education* / Q000379:methods; D002983:Clinical Competence; D004502:Education, Medical, Continuing; D019160:Endosonography / Q000592:standards*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D011446:Prospective Studies