ALFIE: Airway Low Fidelity Including Endobronchial Ultrasound Bio-simulator

Title: ALFIE: Airway Low Fidelity Including Endobronchial Ultrasound Bio-simulator
Author(s): AM Sweeney K Deasy B O'Reilly M Kennedy
Institution: Cork University Hospital
Poster: Click to view poster
Category: Lung Cancer and Bronchoscopy
Abstract: The COVID-19 pandemic has prioritised the role of simulation-based training. Both high and low fidelity simulators in bronchoscopy including endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) are costly. The purpose of this research was to develop a low fidelity bio-simulator from predominately recyclable household materials and to demonstrate its utility in EBUS-TBNA skills training.

The ALFIE (Airway Low Fidelity Including EBUS) bio-simulator was developed from household and plumbing materials with organic materials (fruit) used as pseudo-peri-bronchial lymph nodes. Residents (novices) and fellows (advanced trainees) were tested using a modified validated EBUS-TBNA scoring tool before and after training on the bio-simulator. EBUS scope handling score, EBUS-TBNA score and a combined EBUS score were calculated.

19 trainees (11 residents, 8 fellows) were included. Pre-training assessment of EBUS scope handling differentiated novices from experienced bronchoscopists (p=0.0005 (95% confidence intervals 1.3-2.95)). Novice EBUS scope handling scores improved after training (p=0.0011 (95% confidence intervals 0.41-1.22)). Significant improvements in EBUS-TBNA score (p=0.0011 (n=7, 95% confidence intervals 0.35-5.09)) and total EBUS score (p=0.0472 (95% confidence intervals 0.03-1.4.65)) were identified in fellows after training.

Assessment of scope handling on ALFIE differentiated novices from more experienced bronchoscopists. Trainees’ bronchoscopy skills improved with training on ALFIE bio-simulator.