Learning Gain and Skill Retention Following Unstructured Bronchoscopy Simulation in a Low-fidelity Airway Model

Area of Science:

• Medical Education
• Surgical Simulation
• Respiratory Medicine

Background:

• Simulation is crucial for effective bronchoscopy training, with studies showing improved outcomes.
• Both low-fidelity and high-fidelity simulators support structured training programs.
• This study investigates skill acquisition and retention after unstructured simulation exposure.

Purpose of the Study:

• To assess learning gains in bronchoscopic dexterity after a single, brief, unstructured simulation session.
• To determine if these acquired skills are maintained 8 weeks later without further practice.
• To identify specific skills that may deteriorate more rapidly.

Main Methods:

• Medical students underwent a 45-minute, self-directed, low-fidelity bronchoscopy simulation.
• Bronchoscopic dexterity was evaluated using time to enter a target bronchus and the modified Bronchoscopy Skills and Tasks Assessment Tool (mBSTAT).
• Assessments were conducted at baseline, immediately post-simulation, and 8 weeks later.

Main Results:

• A single simulation session significantly improved mBSTAT scores (3.7 to 7.0, P<0.001).
• Skills significantly deteriorated by 8 weeks (5.7, P=0.03) but remained above baseline (P=0.002).
• All assessed domains, except Precision, showed trends toward deterioration.

Conclusions:

• A brief, unstructured bronchoscopy simulation can significantly enhance bronchoscopic dexterity.
• Significant skill decay occurs after 8 weeks without exposure, highlighting the need for repeated simulation.
• Repeat simulation sessions are recommended to sustain proficiency in bronchoscopy skills.