Variable Learning Curve of Basic Rigid Bronchoscopy in Trainees.

Area of Science:

• Medical Education
• Pulmonology
• Interventional Pulmonology

Background:

• Rigid bronchoscopy (RB) is increasingly used for therapeutic purposes.
• Professional societies recommend performance-based competency assessment for RB.
• A standardized tool to measure trainee competency in clinical RB settings was lacking.

Purpose of the Study:

• To evaluate the Rigid Bronchoscopy Tool for Assessment of Skills and Competence (RIGID-TASC).
• To determine the RB learning curve for interventional pulmonary (IP) trainees in a clinical environment.
• To explore the variability in learning curves among trainees.

Main Methods:

• IP fellows from 4 institutions participated.
• Faculty scored all patient RBs using RIGID-TASC post-simulation training.
• Competency was defined as 3 consecutive successful unassisted RBs with a minimum score of 89.

Main Results:

• Twelve fellows performed 178 RBs, achieving competency between 5 and 24 procedures (median 15).
• Learning curve parameters (start, slope, inflection) varied significantly among trainees.
• Mastering first-attempt intubation and achieving <60s intubation time required the most procedures (median 10).

Conclusions:

• Trainees acquire rigid bronchoscopy skills at a variable pace.
• The RIGID-TASC tool is effective for assessing the clinical learning curve of IP trainees.