Evaluation of a bronchoscopy guidance system for bronchoscopy training, a randomized controlled trial

Abstract

BackgroundConventional training in bronchoscopy is performed either on patients (apprenticeship model) or phantoms. While the former is associated with increased rate of patient complications, procedure time, and amount of sedation, the latter does not offer any form of feedback to the trainee. This paper presents a study which investigates whether a bronchoscopy guidance system may be a helpful tool for training of novice bronchoscopists.MethodsA randomized controlled study with 48 medical students was carried out with two different groups (control and test group, each N = 24). Whereas the control group performed a conventional bronchoscopy on phantom the test group carried out an Electromagnetic Navigation Bronchoscopy (ENB) for tracking of the bronchoscopal tip in the bronchial system. All volunteers had a common task: to perform a complete and systematic diagnostic bronchoscopy within 10 min.ResultsThe test group examined significantly more lobes than the control group (p = 0.009). Due to the real-time feedback of the system, all students of test group felt more confident having analyzed the entire lung. Additionally, they were unanimous that the system would be helpful during the next bronchoscopy.ConclusionsIn sum, this technology may play a major role in unsupervised learning by improving accuracy, dexterity but above all by increasing the confidence of novices, students as well as physicians. Due to good acceptance, there may be a great potential of this tool in clinical routine.

A Comparative Review of the Detection of Early-stage Lung Cancer by Exosomal and Free Nucleic Acids and Standard Screening Methods

“…A bronchoscope is employed to both visualise and remove samples from suspected lung tissue and is essential for the diagnosis of airway lesions and parenchymal lung disorders. In a detailed review by Fullmann et al, 69 its utility for the diagnosis of peripheral pulmonary nodules is shown to be limited. Since lung tissue is heterogeneous and affects the early detection of tumors, tissue biopsies may not be unambiguous.…”

Simulation‐based bronchoscopy training: Randomized trial comparing worked example to video introduction

“…In the traditional teaching method (“see one, do one, teach one”), apprentices perform the procedure directly on the patient under the supervision of experienced professionals. Although this method is commonly regarded as safe, there is a risk of complications, especially in the early stages of learning, due to the apprentice's inexperience and stress 2 …”