Predictors of virtual reality simulation bronchoscopy performance among novice bronchoscopists

Simulation-based training is gradually replacing the classic "apprenticeship" training model. Predictors of better performance of virtual reality simulation bronchoscopy are not clear.

We aim to explore the predictors of performance of simulation bronchoscopy among novice bronchoscopists.

This is a descriptive observational cohort study conducted at King Abdulaziz University Clinical Skills and Simulation Center, Jeddah, Saudi Arabia. All participants filled a demographic questionnaire and attended a pre-simulation orientation about the requested tasks. The Simbionix bronchoscopy simulator was used in this study. First, each resident performed three trails of basic scope manipulation task to test hand-eye coordination skills. Thereafter, each resident performed the guided anatomical navigation task to accurately examine as many lung segments as possible. Results and metrics were retrieved from the simulator, and statistical analysis was performed using t-test to measure statistically significant P-value (<0.05).

Fifty-three internal medicine residents participated in this study. Male residents significantly achieved higher score in the basic scope manipulation task than female residents (65% vs 46%, P<0.001). Furthermore, the percentage of time spent at mid lumen during the scope manipulation was significantly higher for males compared to female residents (48% vs 37%, P=0.003). Residents who were interested in pursuing procedure-based specialty training spent significantly less time in contact with wall (14.6% vs 20.3%, P=0.045). Smokers needed more time to finish the first task (mean 2.5 minutes vs mean 1.1 minutes, P=0.005).

Simulation bronchoscopy performance was different between genders, smoking status and future interest in pursuing a procedure-based career. Overall, male residents performed better than female residents in basic scope manipulation. Gender differences in performing simulation bronchoscopy need to be examined in future studies. Tailored educational programs may be needed to fit gender-specific skills and requirements as well as future career interests.