A Multicenter Study Assessing Interventional Pulmonary Fellow Competency in Electromagnetic Navigation Bronchoscopy

Hans J. Lee; A. Christine Argento; Hitesh Batra; Sadia Benzaquen; Kyle Bramley; David Chambers; Neeraj Desai; H. Erhan Dincer; J. Scott Ferguson; Satish Kalanjeri; Carla Lamb; Nikhil Meena; Chakravarthy Reddy; Alberto Revelo; Ashutosh Sachdeva; Benjamin Seides; Harsh Shah; Samira Shojaee; David Sonetti; Jeffrey Thiboutot; Jennifer Toth; Keriann Van Nostrand; Jason A. Akulian

doi:10.34197/ats-scholar.2021-0121OC

A Multicenter Study Assessing Interventional Pulmonary Fellow Competency in Electromagnetic Navigation Bronchoscopy

Hans J. Lee, A. Christine Argento, Hitesh Batra, Sadia Benzaquen, Kyle Bramley, David Chambers, Neeraj Desai, H. Erhan Dincer, J. Scott Ferguson, Satish Kalanjeri, Carla Lamb, Nikhil Meena, Chakravarthy Reddy, Alberto Revelo, Ashutosh Sachdeva, Benjamin Seides, Harsh Shah, Samira Shojaee, David Sonetti, Jeffrey ThiboutotJennifer Toth, Keriann Van Nostrand, Jason A. Akulian

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Current medical society guidelines recommend a procedural number for obtaining electromagnetic navigational bronchoscopy (ENB) competency and for institutional volume for training. Objective: To assess learning curves and estimate the number of ENB procedures for interventional pulmonology (IP) fellows to reach competency.

Methods: We conducted a prospective multicenter study of IP fellows in the United States learning ENB. A tool previously validated in a similar population was used to assess IP fellows by their local faculty and two blinded independent reviewers using virtual recording of the procedure. Competency was determined by performing three consecutive procedures with a competency score on the assessment tool. Procedural time, faculty global rating scale, and periprocedural complications were also recorded. Results: A total of 184 ENB procedures were available for review with assessment of 26 IP fellows at 16 medical centers. There was a high correlation between the two blinded independent observers (rho = 0.8776). There was substantial agreement for determination of procedural competency between the faculty assessment and blinded reviewers (kappa = 0.7074; confidence interval, 0.5667–0.8482). The number of procedures for reaching competency for ENB bronchoscopy was determined (median, 4; mean, 5; standard deviation, 3.83). There was a wide variation in the number of procedures to reach competency, ranging from 2 to 15 procedures. There were six periprocedural complications reported, four (one pneumomediastinum, three pneumothorax) of which occurred before reaching competence and two pneumothoraces after achieving competence. Conclusion: There is a wide variation in acquiring competency for ENB among IP fellows. Virtual competency assessment has a potential role but needs further studies.

Original language	English (US)
Pages (from-to)	220-228
Number of pages	9
Journal	ATS Scholar
Volume	3
Issue number	2
DOIs	https://doi.org/10.34197/ats-scholar.2021-0121OC
State	Published - Jun 2022

Keywords

bronchoscopy
fellows
learning curve

ASJC Scopus subject areas

Critical Care and Intensive Care Medicine
Clinical Neurology
Education
Pulmonary and Respiratory Medicine

Access to Document

10.34197/ats-scholar.2021-0121OC

Cite this

Lee, H. J., Argento, A. C., Batra, H., Benzaquen, S., Bramley, K., Chambers, D., Desai, N., Dincer, H. E., Ferguson, J. S., Kalanjeri, S., Lamb, C., Meena, N., Reddy, C., Revelo, A., Sachdeva, A., Seides, B., Shah, H., Shojaee, S., Sonetti, D., ... Akulian, J. A. (2022). A Multicenter Study Assessing Interventional Pulmonary Fellow Competency in Electromagnetic Navigation Bronchoscopy. ATS Scholar, 3(2), 220-228. https://doi.org/10.34197/ats-scholar.2021-0121OC

Lee, HJ , Argento, AC, Batra, H, Benzaquen, S, Bramley, K, Chambers, D, Desai, N, Dincer, HE, Ferguson, JS, Kalanjeri, S, Lamb, C, Meena, N, Reddy, C, Revelo, A, Sachdeva, A, Seides, B, Shah, H, Shojaee, S, Sonetti, D, Thiboutot, J, Toth, J, Van Nostrand, K & Akulian, JA 2022, 'A Multicenter Study Assessing Interventional Pulmonary Fellow Competency in Electromagnetic Navigation Bronchoscopy', ATS Scholar, vol. 3, no. 2, pp. 220-228. https://doi.org/10.34197/ats-scholar.2021-0121OC

@article{4a446f6c48184ba28ef33a80401fa4a5,

title = "A Multicenter Study Assessing Interventional Pulmonary Fellow Competency in Electromagnetic Navigation Bronchoscopy",

abstract = "Background: Current medical society guidelines recommend a procedural number for obtaining electromagnetic navigational bronchoscopy (ENB) competency and for institutional volume for training. Objective: To assess learning curves and estimate the number of ENB procedures for interventional pulmonology (IP) fellows to reach competency.Methods: We conducted a prospective multicenter study of IP fellows in the United States learning ENB. A tool previously validated in a similar population was used to assess IP fellows by their local faculty and two blinded independent reviewers using virtual recording of the procedure. Competency was determined by performing three consecutive procedures with a competency score on the assessment tool. Procedural time, faculty global rating scale, and periprocedural complications were also recorded. Results: A total of 184 ENB procedures were available for review with assessment of 26 IP fellows at 16 medical centers. There was a high correlation between the two blinded independent observers (rho = 0.8776). There was substantial agreement for determination of procedural competency between the faculty assessment and blinded reviewers (kappa = 0.7074; confidence interval, 0.5667–0.8482). The number of procedures for reaching competency for ENB bronchoscopy was determined (median, 4; mean, 5; standard deviation, 3.83). There was a wide variation in the number of procedures to reach competency, ranging from 2 to 15 procedures. There were six periprocedural complications reported, four (one pneumomediastinum, three pneumothorax) of which occurred before reaching competence and two pneumothoraces after achieving competence. Conclusion: There is a wide variation in acquiring competency for ENB among IP fellows. Virtual competency assessment has a potential role but needs further studies.",

keywords = "bronchoscopy, fellows, learning curve",

author = "Lee, {Hans J.} and Argento, {A. Christine} and Hitesh Batra and Sadia Benzaquen and Kyle Bramley and David Chambers and Neeraj Desai and Dincer, {H. Erhan} and Ferguson, {J. Scott} and Satish Kalanjeri and Carla Lamb and Nikhil Meena and Chakravarthy Reddy and Alberto Revelo and Ashutosh Sachdeva and Benjamin Seides and Harsh Shah and Samira Shojaee and David Sonetti and Jeffrey Thiboutot and Jennifer Toth and {Van Nostrand}, Keriann and Akulian, {Jason A.}",

note = "Publisher Copyright: Copyright {\textcopyright} 2022 by the American Thoracic Society.",

year = "2022",

month = jun,

doi = "10.34197/ats-scholar.2021-0121OC",

language = "English (US)",

volume = "3",

pages = "220--228",

journal = "ATS Scholar",

issn = "2690-7097",

publisher = "American Thoracic Society",

number = "2",

}

TY - JOUR

T1 - A Multicenter Study Assessing Interventional Pulmonary Fellow Competency in Electromagnetic Navigation Bronchoscopy

AU - Lee, Hans J.

AU - Argento, A. Christine

AU - Batra, Hitesh

AU - Benzaquen, Sadia

AU - Bramley, Kyle

AU - Chambers, David

AU - Desai, Neeraj

AU - Dincer, H. Erhan

AU - Ferguson, J. Scott

AU - Kalanjeri, Satish

AU - Lamb, Carla

AU - Meena, Nikhil

AU - Reddy, Chakravarthy

AU - Revelo, Alberto

AU - Sachdeva, Ashutosh

AU - Seides, Benjamin

AU - Shah, Harsh

AU - Shojaee, Samira

AU - Sonetti, David

AU - Thiboutot, Jeffrey

AU - Toth, Jennifer

AU - Van Nostrand, Keriann

AU - Akulian, Jason A.

PY - 2022/6

Y1 - 2022/6

N2 - Background: Current medical society guidelines recommend a procedural number for obtaining electromagnetic navigational bronchoscopy (ENB) competency and for institutional volume for training. Objective: To assess learning curves and estimate the number of ENB procedures for interventional pulmonology (IP) fellows to reach competency.Methods: We conducted a prospective multicenter study of IP fellows in the United States learning ENB. A tool previously validated in a similar population was used to assess IP fellows by their local faculty and two blinded independent reviewers using virtual recording of the procedure. Competency was determined by performing three consecutive procedures with a competency score on the assessment tool. Procedural time, faculty global rating scale, and periprocedural complications were also recorded. Results: A total of 184 ENB procedures were available for review with assessment of 26 IP fellows at 16 medical centers. There was a high correlation between the two blinded independent observers (rho = 0.8776). There was substantial agreement for determination of procedural competency between the faculty assessment and blinded reviewers (kappa = 0.7074; confidence interval, 0.5667–0.8482). The number of procedures for reaching competency for ENB bronchoscopy was determined (median, 4; mean, 5; standard deviation, 3.83). There was a wide variation in the number of procedures to reach competency, ranging from 2 to 15 procedures. There were six periprocedural complications reported, four (one pneumomediastinum, three pneumothorax) of which occurred before reaching competence and two pneumothoraces after achieving competence. Conclusion: There is a wide variation in acquiring competency for ENB among IP fellows. Virtual competency assessment has a potential role but needs further studies.

AB - Background: Current medical society guidelines recommend a procedural number for obtaining electromagnetic navigational bronchoscopy (ENB) competency and for institutional volume for training. Objective: To assess learning curves and estimate the number of ENB procedures for interventional pulmonology (IP) fellows to reach competency.Methods: We conducted a prospective multicenter study of IP fellows in the United States learning ENB. A tool previously validated in a similar population was used to assess IP fellows by their local faculty and two blinded independent reviewers using virtual recording of the procedure. Competency was determined by performing three consecutive procedures with a competency score on the assessment tool. Procedural time, faculty global rating scale, and periprocedural complications were also recorded. Results: A total of 184 ENB procedures were available for review with assessment of 26 IP fellows at 16 medical centers. There was a high correlation between the two blinded independent observers (rho = 0.8776). There was substantial agreement for determination of procedural competency between the faculty assessment and blinded reviewers (kappa = 0.7074; confidence interval, 0.5667–0.8482). The number of procedures for reaching competency for ENB bronchoscopy was determined (median, 4; mean, 5; standard deviation, 3.83). There was a wide variation in the number of procedures to reach competency, ranging from 2 to 15 procedures. There were six periprocedural complications reported, four (one pneumomediastinum, three pneumothorax) of which occurred before reaching competence and two pneumothoraces after achieving competence. Conclusion: There is a wide variation in acquiring competency for ENB among IP fellows. Virtual competency assessment has a potential role but needs further studies.

KW - bronchoscopy

KW - fellows

KW - learning curve

UR - http://www.scopus.com/inward/record.url?scp=85144804169&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85144804169&partnerID=8YFLogxK

U2 - 10.34197/ats-scholar.2021-0121OC

DO - 10.34197/ats-scholar.2021-0121OC

M3 - Article

C2 - 35924198

AN - SCOPUS:85144804169

SN - 2690-7097

VL - 3

SP - 220

EP - 228

JO - ATS Scholar

JF - ATS Scholar

IS - 2

ER -

A Multicenter Study Assessing Interventional Pulmonary Fellow Competency in Electromagnetic Navigation Bronchoscopy

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this