title: A Comparison of Different Training Methods in the Successful Learning of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration.
abstract: BACKGROUND
  Standardized training of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS- TBNA) is available only in highly developed countries.
  
  
  OBJECTIVE
  To compare the skill differences in the performance of EBUS-TBNA by pulmonologists trained under different learning methods.
  
  
  METHODS
  We performed a retrospective study of 145 EBUS-TBNA cases. We set up 3 comparative training groups: a standardized training group, a teaching group, and a self-study group. The main clinical outcomes were sensitivity, specificity and accuracy of EBUS-TBNA. Cumulative sum analysis was used to track EBUS-TBNA proficiency of the 3 groups.
  
  
  RESULTS
  The sensitivities of EBUS-TBNA in the different groups were 90, 88, and 67%, respectively. The accuracies of the different groups were 91, 90, and 71%, respectively. With respect to the sensitivity and accuracy, there was no significant difference between the standardized training group and teaching group. However, the self-study group was inferior to the other 2 groups. By comparing the learning curve among the groups, we found that the minimum number of operations needed to reach a 90% accuracy for the standardized training group, the teaching group and the self-study group was 17, 32 and 40 cases, respectively.
  
  
  CONCLUSIONS
  Compared with the teaching and self-study groups, the standardized training group resulted in practitioners achieving high skill levels following the performance of a lower number of cases. Pulmonologists trained in the teaching group achieved a similar level of skills, but required more experience to reach this level. Practitioners in the self-study group did not achieve a satisfactory level of skills, despite performing a high number of cases.
authors.affiliation: Department of Respiratory Medicine, RuiJin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, PR China.
authors.forename: Wen Chao
authors.initials: WC
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Jian Ping
authors.initials: JP
authors.lastname: Zhou
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Lerner
authors.forename: Lei
authors.initials: L
authors.lastname: Ni
authors.forename: Ji Min
authors.initials: JM
authors.lastname: Shen
authors.forename: Tian Li
authors.initials: TL
authors.lastname: Yan
authors.forename: Min
authors.initials: M
authors.lastname: Zhou
authors.forename: Guo Chao
authors.initials: GC
authors.lastname: Shi
authors.forename: Yi
authors.initials: Y
authors.lastname: Xiang
mesh_terms: D000328:Adult; D000368:Aged; D001999:Bronchoscopy / Q000009:adverse effects / Q000193:education* / Q000379:methods; D004502:Education, Medical, Continuing / Q000379:methods*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D059032:Learning Curve; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D012189:Retrospective Studies