Evaluating Fellowship Training for Endobronchial Ultrasound-Transbronchial Needle Aspiration (EBUS-TBNA) Using the...

There are two approaches for endobronchial ultrasound (EBUS) training: the traditional apprenticeship approach involving 'see one, do one, teach one', and the computer-based simulation approach. In the traditional approach, the trainee learns under direct supervision from an expert preceptor while performing on patients. In the latter approach, trainees use a high-fidelity bronchoscopy simulator, undertake a skills assessment exam (Endobronchial Ultrasound Skills and Task Assessment Tool (EBUS-STAT)), and receive supervised patient-based training from experienced clinicians. The primary objective of this study was to determine whether a single-day EBUS-transbronchial needle aspiration (TBNA) training course, using high-fidelity simulation and the EBUS-STAT tool, increased the confidence of pulmonary fellows for performing EBUS-TBNA procedures.

Fellowship confidence was measured using a 10-item questionnaire, the EBUS self-assessment tool (EBUS-SAT). This questionnaire was completed before and after EBUS training. The secondary objectives were to determine whether EBUS-STAT varied by year of training and to evaluate the utility of incorporating the EBUS-TBNA training session into fellowship education.

We found that a single day of EBUS-TBNA training using high-fidelity simulation and the EBUS-STAT tool increased the confidence of the first- and third-year pulmonary fellows. The mean improvements in EBUS-SAT questionnaire scores pre- and post-EBUS training session were 13.3 points (p = 0.002) for the first-year fellows and 8.5 points (p = 0.0001) for the third-year fellows. Regarding the secondary objectives, we found no significant difference between EBUS-STAT scores of the first- and third-year pulmonary fellows (p = 0.71).

Combining high-fidelity bronchoscopy simulator training with the EBUS-STAT assessment tool was found to benefit and improve training in EBUS-TBNA and should be incorporated into fellowship training programs.