A Multicenter Study of Competency Metrics: A Project From the Interventional Chest/Diagnostic Procedures NetWork
A Multicenter Study of Competency Metrics: A Project From the Interventional Chest/Diagnostic Procedures NetWork
Momen M. Wahidi, MD, MBA, FCCP, and colleagues conducted the first prospective multicenter study of performance-based metrics and educational interventions in the learning of bronchoscopy by pulmonary fellows. In this study, two successive cohorts starting their pulmonary fellowship between July 5, 2006, and June 30, 2008, were enrolled in the study. At prespecified milestones, validated tools were used to test their bronchoscopy skills and knowledge: the Bronchoscopy Skills and Tasks Assessment Tool (BSTAT), an objective validated evaluation of bronchoscopy skills with scores ranging from 0 to 24, and written multiple-choice question examinations.
The first cohort of fellows received training in bronchoscopy, as per the standards set by each institution, while the second cohort received training in simulation bronchoscopy and was provided an online bronchoscopy curriculum. There was significant variation among study participants regarding bronchoscopy skills at their 50th bronchoscopy, the number previously set to achieve competency in bronchoscopy. An educational intervention of incorporating simulation bronchoscopy enhanced the speed of acquisition of bronchoscopy skills, as shown by the statistically significant improvement in mean BSTAT scores for 7 of the 8 milestone bronchoscopies (p<0.05). The online curriculum did not improve performance on the written tests; however, compliance of the learners with the curriculum was low. This study proved that performance-based competency metrics can effectively evaluate medical procedure skills. It also proved that educational interventions, such as simulation-based training, can enhance the learning curve of bronchoscopy skills and enable the transfer of skills to the bedside that are learned away from the patients.
