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Design of a Simulation-Based Training for Flexible Bronchoscopy

Kania, Julia (2019) Design of a Simulation-Based Training for Flexible Bronchoscopy.

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Abstract:Background/aim: Medical training based on simulators is a patient-safe and cost-effective addition to the traditional apprenticeship model. Instead of letting patients bear the burden of beginner's mistakes, trainees can acquire skills for flexible bronchoscopy (FB) before the first patient contact on simulators. This study's aim was to gain insight into the required skills for FB, their underlying cognitive aspects (e.g. cues, goals, difficulties) and to what extent they can be trained on simulators. Method: (1) Qualitative Document Analysis of four established FB guidelines and a simulation-based curriculum. (2) Qualitative Interview Study: Four Dutch pulmonologists, one resident and one technical physician performed a diagnostic FB on a virtual reality (VR) simulator (10-22 min.) which was video-recorded. Participants engaged in retrospective think-aloud while watching their performance on video. A semi-structured interview helped clarify concepts and opinions about simulation-based training. Results: Seven skills were identified which are crucial for performing a FB. Participants agreed that only two of them can be trained on the VR simulator: (1) Handling the bronchoscope and (2) Inspecting the airway. For the other skills, the VR simulator was considered too inaccurate to serve as a training modality. The results provide detailed descriptions of a diagnostic FB performance (e.g. cues, goals, difficulties) and the VR simulator’s (in)adequacy for training and assessing these skills. Conclusion: Simulation-based training should combine different types of simulators. The VR simulator’s inaccuracies should be improved to optimize learning experiences. Disagreements about execution of skills should be resolved among experts to reach consensus about what to train and thus, how to assess the level of skill of a trainee. Often discarded but worth mentioning is the VR simulator’s potential to serve as a device for training and assessing decision-making and communication skills by presenting trainees with various medical scenarios (e.g. complications) in which they have to appropriately react and effectively work and communicate with assistants.
Item Type:Essay (Bachelor)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:44 medicine, 77 psychology
Programme:Psychology BSc (56604)
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