Bronchoscopy Training using ALFIETM (Airway Low-Fidelity including Endobronchial Ultrasound Bio-simulator) and Single Use Flexible Bronchoscopy

Title: Bronchoscopy Training using ALFIETM (Airway Low-Fidelity including Endobronchial Ultrasound Bio-simulator) and Single Use Flexible Bronchoscopy
Author(s): KF Deasy AM Sweeney BA O'Reilly MP Kennedy
Institution: Department of Respiratory Medicine, Cork University Hospital
Poster: Click to view poster
Category: Lung Cancer and Bronchoscopy
Abstract: The Covid-19 pandemic has resulted in us reconsidering our traditional teaching modalities to develop newer, dynamic methods of furthering medical education. Both high and low fidelity simulators in bronchoscopy including endobronchial guided transbronchial needle aspiration (EBUS-TBNA) are costly. We considered whether a combination of a low-cost bio-simulator made of recyclable materials (ALFIE) and single use flexible bronchoscopy (SUFB) have the capability of differentiating novices from experts, and the ability to train novices in bronchoscopy?

SHOs and Registrars were invited to training on ALFIE simulator using a commercially available SUFB. Trainees were evaluated individually before and after training using a modified validated Bronchoscopy Skills and Tasks Assessment Tool (B-STAT) including the scope handling, endobronchial biopsy and brushing. Training consisted of 20 minutes of hands-on training using SUFB with ALFIETM simulator.

SHO trainees improved in modified B-STAT after training (p=0.0001 (95% confidence intervals (CI) 4.73-10.27)) All 14/14 SHO trainees improved with training. 4 Registrar trainees improved with training, the results were not significant (p= 0.0638 (95% CI -6.67-13.17). There was a significant improvement in modified B-STAT score after training in the total group (p=0.0001 (95% CI 5.37-8.62)). Registrars outperformed SHO trainees in scope handling before training (p=0.0025 (95% CI 13.12-12.17) and after training (p=0.0144 (95% CI 1.18-9.24)).

Low-Fidelity simulators can be constructed using common reusable or disposable items. SUFBs provide a cheap and mobile platform for bronchoscopy training. Our low-fidelity simulator with SUFB differentiated novices from those with more experience and training was associated with a significant improvement in performance on a modified BSTAT assessment. Commercially available SUFBs have modified copyrighted cable heads for attachment to proprietary screens. A training configuration with a standard HDMI head would allow the use of SUFBs in a remote home training kit.