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Painter N, Monovoukas D, Delecaris AO, Coverstone AM, Zopf DA, Saba TG. Incorporating a Three-Dimensional Printed Airway into a Pediatric Flexible Bronchoscopy Curriculum. ATS Sch 2024; 5:142-153. [PMID: 38633515 PMCID: PMC11022656 DOI: 10.34197/ats-scholar.2023-0078oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/16/2023] [Indexed: 04/19/2024] Open
Abstract
Background Although hands-on simulation plays a valuable role in procedural training, there are limited tools available to teach pediatric flexible bronchoscopy (PFB). Fellowship programs rely on patient encounters, with inherent risk, or high-cost virtual reality simulators that may not be widely available and create education inequalities. Objective Our objective was to study the educational value and transferability of a novel, low-cost, three-dimensional-printed pediatric airway model (3D-AM) for PFB training. Our central hypothesis was that the 3D-AM would have high educational value and would be easily transferrable to learners at different teaching hospitals. Methods The 3D-AM was designed to teach technical bronchoscopy skills, airway anatomy, airway pathology, and bronchoalveolar lavage (BAL). The curriculum was offered to incoming fellows in pediatric pulmonology, pediatric surgery, and pediatric critical care across three different teaching institutions. After course completion, each participant assessed the simulation model(s) with a 5-point Likert scale across six domains: physical attributes, realism of experience, ability to perform tasks, value, relevance, and global impression. The expert instructors assessed the learners' competency using a modified version of the Bronchoscopy Skills and Tasks Assessment Tool. Results A total of 14 incoming fellows participated in the course. The mean scores for the 3D-AM across all six domains and across the three institutions was between 4 and 5, suggesting that learners generally had a favorable impression and a similar experience across different institutions. All learners "agreed" or "strongly agreed" that the course was a valuable use of their time, helped teach technical skills and airway anatomy, and would be useful for extra training during fellowship. Most of the learners correctly identified anatomy, bronchomalacia, and performed a BAL. Wall trauma was observed in 36% of learners. Conclusion The utility, low cost, and transferability of this model may create opportunities for PFB training across different institutions despite resource limitations in the United States and abroad.
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Affiliation(s)
| | | | - Angela O. Delecaris
- Department of Pediatrics, Indiana
University School of Medicine, Indianapolis, Indiana; and
| | - Andrea M. Coverstone
- Department of Pediatrics, Washington
University School of Medicine, St. Louis, Missouri
| | - David A. Zopf
- Department of Otolaryngology–Head
and Neck Surgery, and
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2
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New ML, Amass T, Neumeier A, Jacobson NM, Huie TJ. Creation and Validation of a Massive Hemoptysis Simulator. Chest 2024; 165:636-644. [PMID: 37852436 DOI: 10.1016/j.chest.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Simulation for the management of massive hemoptysis is limited by the absence of a commercially available simulator to practice procedural skills necessary for management. RESEARCH QUESTION Is it feasible to create and validate a hemoptysis simulator with high functional task alignment? STUDY DESIGN AND METHODS Pulmonary and critical care medicine (PCCM) attending physicians from four academic institutions in the Denver, Colorado, area and internal medicine residents from the University of Colorado participated in this mixed-methods study. A hemoptysis simulator was constructed by connecting a 3-D-printed airway model to a manikin that may be intubated. Attending PCCM physicians evaluated the simulator through surveys and qualitative interviews. Attendings were surveyed to determine simulation content and appropriate assessment criteria for a hemoptysis simulation. Based on these criteria, expert and novice performance on the simulator was assessed. RESULTS The manikin-based hemoptysis simulator demonstrated adequate physical resemblance, high functional alignment, and strong affective fidelity. It was universally preferred over a virtual reality simulator by 10 PCCM attendings. Twenty-seven attendings provided input on assessment criteria and established that assessing management priorities (eg, airway protection) was preferred to a skills checklist for hemoptysis management. Three experts outperformed six novices in hemoptysis management on the manikin-based simulator in all management categories assessed, supporting construct validity of the simulation. INTERPRETATION Creation of a hemoptysis simulator with appropriate content, high functional task alignment, and strong affective fidelity was successful using 3-D-printed airway models and existing manikins. This approach can overcome barriers of cost and availability for simulation of high-acuity, low-occurrence procedures.
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Affiliation(s)
- Melissa L New
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Aurora, CO; Rocky Mountain Regional VA Medical Center, Aurora, CO.
| | - Timothy Amass
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Aurora, CO; Denver Health Medical Center, Denver, CO
| | - Anna Neumeier
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Aurora, CO; Denver Health Medical Center, Denver, CO
| | - Nicholas M Jacobson
- College of Engineering, Design and Computing, University of Colorado, Aurora, CO
| | - Tristan J Huie
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Aurora, CO; National Jewish Health, Denver, CO
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3
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Asif A, Lee E, Caputo M, Biglino G, Shearn AIU. Role of 3D printing technology in paediatric teaching and training: a systematic review. BMJ Paediatr Open 2021; 5:10.1136/bmjpo-2021-001050. [PMID: 35290958 PMCID: PMC8655595 DOI: 10.1136/bmjpo-2021-001050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/15/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND In the UK, undergraduate paediatric training is brief, resulting in trainees with a lower paediatric knowledge base compared with other aspects of medicine. With congenital conditions being successfully treated at childhood, adult clinicians encounter and will need to understand these complex pathologies. Patient-specific 3D printed (3DP) models have been used in clinical training, especially for rarer, complex conditions. We perform a systematic review to evaluate the evidence base in using 3DP models to train paediatricians, surgeons, medical students and nurses. METHODS Online databases PubMed, Web of Science and Embase were searched between January 2010 and April 2020 using search terms relevant to "paediatrics", "education", "training" and "3D printing". Participants were medical students, postgraduate trainees or clinical staff. Comparative studies (patient-specific 3DP models vs traditional teaching methods) and non-comparative studies were included. Outcomes gauged objective and subjective measures: test scores, time taken to complete tasks, self-reported confidence and personal preferences on 3DP models. If reported, the cost of and time taken to produce the models were noted. RESULTS From 587 results, 15 studies fit the criteria of the review protocol, with 5/15 being randomised controlled studies and 10/15 focussing on cardiovascular conditions. Participants using 3DP models demonstrated improved test scores and faster times to complete procedures and identify anatomical landmarks compared with traditional teaching methods (2D diagrams, lectures, videos and supervised clinical events). User feedback was positive, reporting greater user self-confidence in understanding concepts with users wishing for integrated use of 3DP in regular teaching. Four studies reported the costs and times of production, which varied depending on model complexity and printer. 3DP models were cheaper than 'off-the-shelf' models available on the market and had the benefit of using real-world pathologies. These mostly non-randomised and single-centred studies did not address bias or report long-term or clinically translatable outcomes. CONCLUSIONS 3DP models were associated with greater user satisfaction and good short-term educational outcomes, with low-quality evidence. Multicentred, randomised studies with long-term follow-up and clinically assessed outcomes are needed to fully assess their benefits in this setting. PROSPERO REGISTRATION NUMBER CRD42020179656.
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Affiliation(s)
- Ashar Asif
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Elgin Lee
- Children's Services Directorate, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Massimo Caputo
- Bristol Medical School, University of Bristol, Bristol, UK.,Bristol Heart Institute, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
| | - Giovanni Biglino
- Bristol Heart Institute, University Hospitals Bristol and Weston NHS Trust, Bristol, UK.,National Heart and Lung Institute, Imperial College London, London, UK
| | - Andrew Ian Underwood Shearn
- Bristol Medical School, University of Bristol, Bristol, UK .,Bristol Heart Institute, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
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Teaching Radial Endobronchial Ultrasound with a Three-Dimensional–printed Radial Ultrasound Model. ATS Sch 2021; 2:606-619. [PMID: 35083464 PMCID: PMC8787737 DOI: 10.34197/ats-scholar.2020-0152oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 08/13/2021] [Indexed: 12/04/2022] Open
Abstract
Background Peripheral pulmonary lesion (PPL) incidence is rising because of increased
chest imaging sensitivity and frequency. For PPLs suspicious for lung
cancer, current clinical guidelines recommend tissue diagnosis. Radial
endobronchial ultrasound (R-EBUS) is a bronchoscopic technique used for this
purpose. It has been observed that diagnostic yield is impacted by the
ability to accurately manipulate the radial probe. However, such skills can
be acquired, in part, from simulation training. Three-dimensional (3D)
printing has been used to produce training simulators for standard
bronchoscopy but has not been specifically used to develop similar tools for
R-EBUS. Objective We report the development of a novel ultrasound-compatible, anatomically
accurate 3D-printed R-EBUS simulator and evaluation of its utility as a
training tool. Methods Computed tomography images were used to develop 3D-printed airway models with
ultrasound-compatible PPLs of “low” and “high”
technical difficulty. Twenty-one participants were allocated to two groups
matched for prior R-EBUS experience. The intervention group received 15
minutes to pretrain R-EBUS using a 3D-printed model, whereas the
nonintervention group did not. Both groups then performed R-EBUS on
3D-printed models and were evaluated using a specifically developed
assessment tool. Results For the “low-difficulty” model, the intervention group achieved
a higher score (21.5 ± 2.02) than the nonintervention
group (17.1 ± 5.7), reflecting 26% improvement
in performance (P = 0.03). For the
“high-difficulty” model, the intervention group scored
20.2 ± 4.21 versus 13.3 ± 7.36,
corresponding to 52% improvement in performance
(P = 0.02). Participants derived
benefit from pretraining with the 3D-printed model, regardless of prior
experience level. Conclusion 3D-printing can be used to develop simulators for R-EBUS education. Training
using these models significantly improves procedural performance and is
effective in both novice and experienced trainees.
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Maier P, Silvestro E, Goldfarb SB, Piccione J, Phinizy PA, Andronikou S. Three-dimensional printed realistic pediatric static and dynamic airway models for bronchoscopy and foreign body removal training. Pediatr Pulmonol 2021; 56:2654-2659. [PMID: 34038029 DOI: 10.1002/ppul.25516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/05/2022]
Abstract
For mastering bronchoscope handling, positioning, and directing of the bronchoscope in response to the intraluminal view provided by the bronchoscope camera, sufficient training is necessary, especially in infants and toddlers who have smaller airways, faster respiratory rates, and higher airway collapsibility. With the use of three-dimensional printing, we aimed to develop a set of anatomically accurate and low-cost airway models for teaching and training of bronchoscopy technique and foreign body removal: a translucent airway box model, a static airway model, and a dynamic airway model consisting of a flexible tree model connected to a pump that allows simulation of airway collapsibility during breathing. Computed tomography (CT) patient data of three different ages (1, 5, and 18 years of age) was imported into Materialise Mimics, segmented, and printed using VisoClear and soft Tango+ material. The models were evaluated by three pediatric pulmonology attendings for anatomical accuracy and usefulness for teaching and training. The translucent airway box model was preferred for the initial presentation of bronchoscope handling and learning anatomy in three dimensions. The static and flexible tree models were used to train bronchoscope handling and foreign body removal. The dynamic model provided the most realistic representation of a pediatric airway throughout the respiratory cycle with increased patency during inspiration and relative collapse during exhalation. Objective verification of anatomical accuracy and physiology of breathing motion was obtained by comparing CT scans of the model with original images and by application of 4D dynamic CT airway imaging protocols, respectively.
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Affiliation(s)
- Pia Maier
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Center for Pediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Elizabeth Silvestro
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Samuel B Goldfarb
- Division of Pulmonary and Sleep Medicine, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - Joseph Piccione
- Division of Pulmonary and Sleep Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Pelton A Phinizy
- Division of Pulmonary and Sleep Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Savvas Andronikou
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Leong A, Benscoter D, Brewington J, Torres‐Silva C, Wood RE. Pediatric flexible airway endoscopy training during a pandemic and beyond: Bending the curve. Pediatr Pulmonol 2021; 56:1386-1388. [PMID: 33559942 PMCID: PMC8012993 DOI: 10.1002/ppul.25311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 11/07/2022]
Affiliation(s)
- Albin Leong
- Department of Clinical Sciences, Pediatric PulmonologyCalifornia Northstate University College of MedicineElk GroveCaliforniaUSA
| | - Dan Benscoter
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOhioUSA
- Division of Pulmonary MedicineCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - John Brewington
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOhioUSA
- Division of Pulmonary MedicineCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Cherie Torres‐Silva
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOhioUSA
- Division of Pulmonary MedicineCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Robert E. Wood
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOhioUSA
- Division of Pulmonary MedicineCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
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Pertile J, Smith B, Mellenthin M, Wagner J, DeBoer EM, Fink DS. Jet flow rate and needle position govern distal airway pressures during low-frequency jet ventilation. Laryngoscope Investig Otolaryngol 2021; 6:244-251. [PMID: 33869756 PMCID: PMC8035948 DOI: 10.1002/lio2.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 12/02/2020] [Accepted: 01/27/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Although jet ventilation is frequently used during surgery for airway stenosis, little is known about distal airway pressures during jet ventilation. The objective of the study is to determine how jet pressure, flow rate, and position of the ventilation needle relate to distal airway pressure magnitude and homogeneity. METHODS Two 3D models of the first five generations of the human airway tree were created. One is a duplicate of a human airway from a 15-year-old healthy male's computed tomography scan, and the other is an idealized symmetric model of human lung morphometry. Pressure transducers measured fifth-generation distal airway pressures in both models. A computer-controlled jet needle positioning system was used to ventilate the lung casts. The effects of jet needle position, jet pressure, and jet flow rate on distal airway pressure and homogeneity were measured. RESULTS Total entrained jet flow rate was the most reliable predictor of distal airway pressure. Pressure supplied to the jet ventilation needle had a positive linear relationship with distal airway pressure; however, this relationship was dependent on the jet needle flow resistance. As the ventilation needle moved closer to the tracheal wall, ventilation homogeneity decreased. Depth into the trachea was positively correlated with sensitivity of the needle to the tracheal wall. CONCLUSION In this model, total entrained jet flow rate is a more robust predictor of distal airway pressure than jet inlet pressure. More homogeneous ventilation was observed in our model with the ventilation needle centered in the proximal region of the trachea.
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Affiliation(s)
- Joshua Pertile
- Department of BioengineeringUniversity of Colorado DenverAnschutz Medical CampusAuroraColoradoUSA
| | - Bradford Smith
- Department of BioengineeringUniversity of Colorado DenverAnschutz Medical CampusAuroraColoradoUSA
- Department of Pediatrics, School of MedicineUniversity of ColoradoAuroraColoradoUSA
| | - Michelle Mellenthin
- Department of BioengineeringUniversity of Colorado DenverAnschutz Medical CampusAuroraColoradoUSA
- Department of Computer Science and EngineeringColorado Mesa UniversityGrand JunctionColoradoUSA
| | - Jennifer Wagner
- Department of BioengineeringUniversity of Colorado DenverAnschutz Medical CampusAuroraColoradoUSA
| | - Emily M. DeBoer
- Department of Pediatrics, School of MedicineUniversity of ColoradoAuroraColoradoUSA
| | - Daniel S. Fink
- Department of Otolaryngology, School of MedicineUniversity of ColoradoAuroraColoradoUSA
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8
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Boshra M, Godbout J, Perry JJ, Pan A. 3D printing in critical care: a narrative review. 3D Print Med 2020; 6:28. [PMID: 32997313 PMCID: PMC7525075 DOI: 10.1186/s41205-020-00081-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND 3D printing (3DP) has gained interest in many fields of medicine including cardiology, plastic surgery, and urology due to its versatility, convenience, and low cost. However, critical care medicine, which is abundant with high acuity yet infrequent procedures, has not embraced 3DP as much as others. The discrepancy between the possible training or therapeutic uses of 3DP in critical care and what is currently utilized in other fields needs to be addressed. OBJECTIVE This narrative literature review describes the uses of 3DP in critical care that have been documented. It also discusses possible future directions based on recent technological advances. METHODS A literature search on PubMed was performed using keywords and Mesh terms for 3DP, critical care, and critical care skills. RESULTS Our search found that 3DP use in critical care fell under the major categories of medical education (23 papers), patient care (4 papers) and clinical equipment modification (4 papers). Medical education showed the use of 3DP in bronchoscopy, congenital heart disease, cricothyroidotomy, and medical imaging. On the other hand, patient care papers discussed 3DP use in wound care, personalized splints, and patient monitoring. Clinical equipment modification papers reported the use of 3DP to modify stethoscopes and laryngoscopes to improve their performance. Notably, we found that only 13 of the 31 papers were directly produced or studied by critical care physicians. CONCLUSION The papers discussed provide examples of the possible utilities of 3DP in critical care. The relative scarcity of papers produced by critical care physicians may indicate barriers to 3DP implementation. However, technological advances such as point-of-care 3DP tools and the increased demand for 3DP during the recent COVID-19 pandemic may change 3DP implementation across the critical care field.
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Affiliation(s)
- Mina Boshra
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd., Ottawa, ON K1H8M5 Canada
| | - Justin Godbout
- Department of Emergency Medicine, Faculty of Medicine, University of Ottawa, 1053 Carling Avenue, Ottawa, ON K1Y 4E9 Canada
| | - Jeffrey J. Perry
- Department of Emergency Medicine, Faculty of Medicine, University of Ottawa, 1053 Carling Avenue, Ottawa, ON K1Y 4E9 Canada
- Department of Emergency Medicine, The Ottawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, Ontario K1Y 4E9 Canada
| | - Andy Pan
- Department of Emergency Medicine, Faculty of Medicine, University of Ottawa, 1053 Carling Avenue, Ottawa, ON K1Y 4E9 Canada
- Department of Emergency Medicine, The Ottawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, Ontario K1Y 4E9 Canada
- Division of Critical Care Medicine, Department of Medicine, Montfort Hospital, 713 Montreal Road, Ottawa, ON K1K 0T2 Canada
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9
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Leong TL, Li J. 3D printed airway simulators: Adding a dimension to bronchoscopy training. Respirology 2020; 25:1126-1128. [PMID: 32830872 DOI: 10.1111/resp.13933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 08/07/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Tracy L Leong
- Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Victoria, Australia.,Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.,Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Jasun Li
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.,Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia.,3dMedLab, Austin Health, Melbourne, Victoria, Australia
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Follmann A, Pereira CB, Knauel J, Rossaint R, Czaplik M. Evaluation of a bronchoscopy guidance system for bronchoscopy training, a randomized controlled trial. BMC MEDICAL EDUCATION 2019; 19:430. [PMID: 31752847 PMCID: PMC6868732 DOI: 10.1186/s12909-019-1824-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 09/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Conventional 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. METHODS A 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. RESULTS The 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. CONCLUSIONS In 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.
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Affiliation(s)
- Andreas Follmann
- Department of Anesthesiology, University Hospital RWTH Aachen, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - Carina Barbosa Pereira
- Department of Anesthesiology, University Hospital RWTH Aachen, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - Julia Knauel
- Department of Anesthesiology, University Hospital RWTH Aachen, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - Rolf Rossaint
- Department of Anesthesiology, University Hospital RWTH Aachen, Pauwelsstr. 30, D-52074 Aachen, Germany
| | - Michael Czaplik
- Department of Anesthesiology, University Hospital RWTH Aachen, Pauwelsstr. 30, D-52074 Aachen, Germany
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