Document Detail

Trainee Impact on Advanced Diagnostic Bronchoscopy: An Analysis of 607 Consecutive Procedures in an Interventional Pulmonary Practice.
MedLine Citation:
PMID:  23016797     Owner:  NLM     Status:  Publisher    
SUMMARY AT A GLANCE: Trainees can negatively impact advanced bronchoscopy. ABSTRACT: Background and Objective:  Complications during advanced diagnostic bronchoscopy are rare and include: pneumothorax, bleeding, mediastinitis, pericarditis and lymphadenitis. Increased complications have been demonstrated in patients undergoing routine bronchoscopy procedures performed by trainees. This study aimed to determine the impact of trainees during advanced diagnostic bronchoscopy on procedure time, sedation use and complications. Methods:  A retrospective review of a quality improvement database was performed including consecutive pulmonary procedures performed by an interventional pulmonologist (D.R.S.) at the University of Calgary, from July 1st, 2007 to April 1(st) , 2011. Results:  607 (55.2%) of the 1100 procedures in the database involved an advanced diagnostic procedure defined as: endobronchial ultrasound (EBUS) guided transbronchial needle aspiration, electromagnetic navigation bronchoscopy (ENB) and/or peripheral EBUS. A trainee participated in 512 (84.3%) of these procedures. A complication occurred in 25 patients (4.1%), with a trend towards increased complication rates in the trainee group [4.7% versus 1.1%, difference 3.6%, p=0.076]. Significant differences were seen when a trainee participated versus when no trainee participated for procedure length [58.32 versus 37.69 minutes, difference 20.63 minutes (95% C.I. 19.07-22.19), p=0.001] and for the dose of propofol used [178.3 versus 137.1 mg, difference 41.2 mg (95% C.I. 19.81-63.38), p=0.002]. Conclusions:  In an academic interventional pulmonology practice utilizing the apprenticeship model for bronchoscopy education, trainee participation in advanced diagnostic bronchoscopy increased procedure time, increased the amount of sedation used and resulted in a trend to increased complications. Attempts to modify trainee procedural training to reduce the burden of procedural learning for patients are warranted. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.
David Ryan Stather; Paul Maceachern; Alex Chee; Elaine Dumoulin; Alain Tremblay
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-27
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1843     ISO Abbreviation:  Respirology     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.
Division of Respiratory Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada.
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