Multimodality Education for Airway Endoscopy Skill Development

Abstract

Objectives: We evaluated lymphosonography, or contrast-enhanced, ultrasonography (US)-guided sentinel lymph node (SLN) detection, as a technique for demonstrating the lymphatic drainage of the thyroid gland. Methods: In this prospective animal study, four 50-kg Yorkshire swine underwent transcutaneous injection of a US contrast agent and methylene blue dye into the thyroid gland. Contrast-enhanced US was used to identify draining lymphatic channels and SLNs. Sentinel node biopsy was conducted. Subsequently, bilateral neck and upper mediastinal dissection was carried out. Results: In 3 of 4 cases, a blue dye-positive and US contrast-positive SLN was identified. We identified SLNs in level IV in 2 cases. One case revealed 2 adjacent nodes in the superior mediastinum. In 1 case, a lymphatic channel was identified traveling into the mediastinum, but exposure of the SLN could not be obtained. No residual blue dye-positive or US contrast-positive nodes were identified on subsequent dissection. Conclusions: Lymphosonography of the thyroid gland in a porcine model correlates well with blue dye-guided sentinel node biopsy and is technically feasible, although in some cases access to the SLN may be difficult. This technique could potentially enable a detailed analysis of thyroidal lymphatic drainage if applied to humans.

Technology-Enhanced Simulation and Pediatric Education: A Meta-analysis

“…[26][27][28][29][30][31][32] We narratively discuss the other studies with nonrecurrent themes. [33][34][35][36][37][38][39][40][41][42][43] …”

“…38 Virtual reality training: a 2-group nonrandomized study comparing high-fidelity simulation versus virtual reality for teaching airway endoscopy skills to otolaryngology residents and pediatric surgery fellows showed an association with high-fidelity simulation (N = 36, ES = 0.543) and enhanced nontime skills. 39 Type of feedback: 1 randomized study compared the type of corrective feedback given to learners during cardiopulmonary resuscitation training. The combination of instructor and automated feedback (from the defibrillator) during training versus instructor feedback only demonstrated large effects favoring combined feedback for nontime skills immediately after the intervention (N = 69, ES = 1.454).…”

Developments in Simulation Bronchoscopy Training

“…A recent systematic review and meta-analysis of simulation based bronchoscopy training incorporated additional studies [42]. These studies included animal models, manikins, designed artificial models or VRS bronchoscopy and endobronchial ultrasound training [26,[43][44][45][46][47][48][49]. These studies used various differing models and demonstrated benefits from using simulation for purpose of bronchoscopy training.…”

Simulation-Based Training in Flexible Bronchoscopy and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA): A Systematic Review

“…The remaining studies [13, 19-23, 27, 28, 32, 34, 37, 38] either tested various training methods [20,27,28,32,34,37,38] , simulators [21][22][23]28] or a new approach to skills assessment [13,19] .…”