title: Teaching basic lung isolation skills on human anatomy simulator: attainment and retention of lung isolation skills.
abstract: BACKGROUND
  Lung isolation skills, such as correct insertion of double lumen endobronchial tube and bronchial blocker, are essential in anesthesia training; however, how to teach novices these skills is underexplored. Our aims were to determine (1) if novices can be trained to a basic proficiency level of lung isolation skills, (2) whether video-didactic and simulation-based trainings are comparable in teaching lung isolation basic skills, and (3) whether novice learners' lung isolation skills decay over time without practice.
  
  
  METHODS
  First, five board certified anesthesiologist with experience of more than 100 successful lung isolations were tested on Human Airway Anatomy Simulator (HAAS) to establish Expert proficiency skill level. Thirty senior medical students, who were naive to bronchoscopy and lung isolation techniques (Novice) were randomized to video-didactic and simulation-based trainings to learn lung isolation skills. Before and after training, Novices' performances were scored for correct placement using pass/fail scoring and a 5-point Global Rating Scale (GRS); and time of insertion was recorded. Fourteen novices were retested 2 months later to assess skill decay.
  
  
  RESULTS
  Experts' and novices' double lumen endobronchial tube and bronchial blocker passing rates showed similar success rates after training (P >0.99). There were no differences between the video-didactic and simulation-based methods. Novices' time of insertion decayed within 2 months without practice.
  
  
  CONCLUSIONS
  Novices could be trained to basic skill proficiency level of lung isolation. Video-didactic and simulation-based methods we utilized were found equally successful in training novices for lung isolation skills. Acquired skills partially decayed without practice.
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, University of Louisville, 530 South Jackson St, Louisville, KY, USA. Rklati01@louisville.edu.|Paris Simulation Center, Office of Medical Education, School of Medicine, University of Louisville, KY, USA. Rklati01@louisville.edu.|Outcomes Research Consortium, Clevland, OH, USA. Rklati01@louisville.edu.
authors.forename: Rana K
authors.initials: RK
authors.lastname: Latif
authors.affiliation: Naval Medical Center, Portsmouth, VA, USA. evanhorne@msn.com.
authors.forename: Edgar M
authors.initials: EM
authors.lastname: VanHorne
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, University of Louisville, 530 South Jackson St, Louisville, KY, USA. s0kanc03@louisville.edu.
authors.forename: Sunitha Kanchi
authors.initials: SK
authors.lastname: Kandadai
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, University of Louisville, 530 South Jackson St, Louisville, KY, USA. alexmdusmle@yahoo.com.|University of Oklahoma, OK, USA. alexmdusmle@yahoo.com.|Outcomes Research Consortium, Clevland, OH, USA. alexmdusmle@yahoo.com.
authors.forename: Alexander F
authors.initials: AF
authors.lastname: Bautista
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, University of Louisville, 530 South Jackson St, Louisville, KY, USA. a0neam01@louisville.edu.
authors.forename: Aurel
authors.initials: A
authors.lastname: Neamtu
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, University of Louisville, 530 South Jackson St, Louisville, KY, USA. anupama.wadhwa@louisville.edu.|Outcomes Research Consortium, Clevland, OH, USA. anupama.wadhwa@louisville.edu.
authors.forename: Anupama
authors.initials: A
authors.lastname: Wadhwa
authors.affiliation: Paris Simulation Center, Office of Medical Education, School of Medicine, University of Louisville, KY, USA. mary.carter@louisville.edu.
authors.forename: Mary B
authors.initials: MB
authors.lastname: Carter
authors.affiliation: Paris Simulation Center, Office of Medical Education, School of Medicine, University of Louisville, KY, USA. craig.zeigler@louisville.edu.
authors.forename: Craig H
authors.initials: CH
authors.lastname: Ziegler
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, University of Louisville, 530 South Jackson St, Louisville, KY, USA. drfmemon@yahoo.com.
authors.forename: Mohammed Faisal
authors.initials: MF
authors.lastname: Memon
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, University of Louisville, 530 South Jackson St, Louisville, KY, USA. ozan.akca@louisville.edu.|Outcomes Research Consortium, Clevland, OH, USA. ozan.akca@louisville.edu.
authors.forename: Ozan
authors.initials: O
authors.lastname: Akça
mesh_terms: D000776:Anesthesiology / Q000193:education* / Q000379:methods; D001999:Bronchoscopy / Q000193:education* / Q000379:methods; D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D005180:Faculty, Medical / Q000592:standards*; D006801:Humans; D008168:Lung; D013337:Students, Medical