A Longitudinal Study of Multimodal Bronchoscopy Training in Uganda

Area of Science:

• Pulmonology
• Medical Education
• Global Health

Background:

• Flexible bronchoscopy is crucial for diagnosing and managing pulmonary diseases.
• Low and middle-income countries (LMICs) face challenges with limited bronchoscopy capacity.
• A pilot flexible bronchoscopy training program was initiated in Kampala, Uganda, in 2019, followed by a 2-year multimodal course.

Purpose of the Study:

• To assess the effectiveness of a longitudinal multimodal bronchoscopy training program in an LMIC.
• To evaluate knowledge retention and procedural competency among Ugandan physicians.
• To determine the efficacy of a follow-up curriculum for both new and returning participants.

Main Methods:

• A multimodal curriculum was co-developed by Ugandan and US pulmonologists.
• Training included lectures, simulations, and proctoring for both new and previously trained physicians.
• Knowledge was assessed via a 12-question multiple-choice exam, and procedural competency was measured using the Bronchoscopic Skills and Tasks Assessment Tool (BSTAT).

Main Results:

• In 2022, participants (n=11) showed improved mean exam scores post-training (43.9 to 59.8, P=0.008), though lower than 2019 scores (90.8).
• Mean BSTAT scores for participants (n=8) remained similar between 2019 (72.1) and 2022 (75.2), indicating sustained procedural competency (P=0.38).

Conclusions:

• A longitudinal multimodal bronchoscopy curriculum can effectively enhance physician competency in LMICs.
• This training approach offers a scalable model for improving pulmonary healthcare in resource-limited settings.
• Sustained proficiency suggests the value of ongoing, multimodal training interventions.