title: Procedural Learning Perspectives of Pulmonary Fellows and Practitioners.
abstract: BACKGROUND
  Procedural learning requires both didactic knowledge and motor skills. Optimal teaching styles and techniques remain to be defined for pulmonary procedural learning. We investigated the preferences of learners at 2 different points in a pulmonary career; as pulmonary fellows and as clinical practitioners.
  
  
  METHODS
  A perception survey was conducted among pulmonary fellows and practitioners from multiple institutions throughout the United States. Fellows and practitioners were immediately surveyed on procedural learning factors after completing a procedural learning course using low/high-fidelity and/or cadaver simulators. Survey questions consisting of biographical information and multiple choice, Likert style, and qualitative questions regarding learning preferences were collected.
  
  
  RESULTS
  Seventy-five physicians (44 pulmonary fellows, 31 practitioners) from 35 centers completed the survey. Pulmonary practitioners preferred an academic expert, whereas fellows preferred familiar faculty as lecturers for procedural learning (P=0.03). There were no statistical differences between fellows/practitioners value of the use of simulators, didactics, or handouts. Both groups preferred animal/cadaver and high-fidelity simulators to low-fidelity simulators. Both groups also preferred a traditional course structure to problem-based learning/flipped classroom. The most common answer to barriers for learning a new procedure was "time" for training followed by "opportunities" to learn.
  
  
  CONCLUSIONS
  Pulmonary fellows and practitioners we surveyed preferred a traditional course structure with cadaver/animal models and high-fidelity simulation training as compared with a flipped classroom model and low-fidelity simulators, but whether this holds true for the wider population is unknown. Larger studies are needed to validate learning perception with outcomes.
authors.affiliation: Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Lee
authors.forename: Briana
authors.initials: B
authors.lastname: Coleman
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Lerner
authors.forename: David
authors.initials: D
authors.lastname: Feller-Kopman
authors.forename: Roy
authors.initials: R
authors.lastname: Semaan
authors.forename: Bernice
authors.initials: B
authors.lastname: Frimpong
authors.forename: Lonny
authors.initials: L
authors.lastname: Yarmus
mesh_terms: D002983:Clinical Competence; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D016544:Patient Simulation; D010820:Physicians; D011795:Surveys and Questionnaires; D014481:United States