TY - JOUR
T1 - Effectiveness of Flexible Bronchoscopy Simulation-Based Training
T2 - A Systematic Review
AU - Gerretsen, Eveline C. F.
AU - Chen, Aoben
AU - Annema, Jouke T.
AU - Groenier, Marleen
AU - van der Heijden, Erik H. F. M.
AU - van Mook, Walther N. K. A.
AU - Smeenk, Frank W. J. M.
N1 - Funding Information:
Author contributions: E. C. F. G. takes responsibility for the content of the manuscript, including the data and analysis. E. C. F. G. J. T. A. M. G. E. H. F. M. v. d. H. W. N. K. A. v. M. and F. W. J. M. S. developed the protocol. E. C. F. G. and A. C. performed the literature search and screened results. E. C. F. G. and A. C. read full texts of relevant papers to decide whether they had to be included or not, and F. W. J. M. S. decided when no consensus could be reached. E. C. F. G. and A. C. assessed included papers on quality and general and instructional features, and F. W. J. M. S. decided when no consensus could be reached. All authors contributed to writing the paper. Role of sponsors: The sponsor had no role in the design of the study, the collection and analysis of the data, or the preparation of the manuscript. Other contributions: We thank Jen Yaros, MSc, for proofreading the manuscript. Additional information: The e-Tables are available online under “Supplementary Data.”
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/10
Y1 - 2023/10
N2 - Background: The implementation of simulation-based training (SBT) to teach flexible bronchoscopy (FB) skills to novice trainees has increased during the last decade. However, it is unknown whether SBT is effective to teach FB to novices and which instructional features contribute to training effectiveness. Research Question: How effective is FB SBT and which instructional features contribute to training effectiveness? Study Design and Methods: We searched Embase, PubMed, Scopus, and Web of Science for articles on FB SBT for novice trainees, considering all available literature until November 10, 2022. We assessed methodological quality of included studies using a modified version of the Medical Education Research Study Quality Instrument, evaluated risk of bias with relevant tools depending on study design, assessed instructional features, and intended to correlate instructional features to outcome measures. Results: We identified 14 studies from an initial pool of 544 studies. Eleven studies reported positive effects of FB SBT on most of their outcome measures. However, risk of bias was moderate or high in eight studies, and only six studies were of high quality (modified Medical Education Research Study Quality Instrument score ≥ 12.5). Moreover, instructional features and outcome measures varied highly across studies, and only four studies evaluated intervention effects on behavioral outcome measures in the patient setting. All of the simulation training programs in studies with the highest methodological quality and most relevant outcome measures included curriculum integration and a range in task difficulty. Interpretation: Although most studies reported positive effects of simulation training programs on their outcome measures, definitive conclusions regarding training effectiveness on actual bronchoscopy performance in patients could not be made because of heterogeneity of training features and the sparse evidence of training effectiveness on validated behavioral outcome measures in a patient setting. Trial Registration: PROSPERO; No.: CRD42021262853; URL: https://www.crd.york.ac.uk/prospero/
AB - Background: The implementation of simulation-based training (SBT) to teach flexible bronchoscopy (FB) skills to novice trainees has increased during the last decade. However, it is unknown whether SBT is effective to teach FB to novices and which instructional features contribute to training effectiveness. Research Question: How effective is FB SBT and which instructional features contribute to training effectiveness? Study Design and Methods: We searched Embase, PubMed, Scopus, and Web of Science for articles on FB SBT for novice trainees, considering all available literature until November 10, 2022. We assessed methodological quality of included studies using a modified version of the Medical Education Research Study Quality Instrument, evaluated risk of bias with relevant tools depending on study design, assessed instructional features, and intended to correlate instructional features to outcome measures. Results: We identified 14 studies from an initial pool of 544 studies. Eleven studies reported positive effects of FB SBT on most of their outcome measures. However, risk of bias was moderate or high in eight studies, and only six studies were of high quality (modified Medical Education Research Study Quality Instrument score ≥ 12.5). Moreover, instructional features and outcome measures varied highly across studies, and only four studies evaluated intervention effects on behavioral outcome measures in the patient setting. All of the simulation training programs in studies with the highest methodological quality and most relevant outcome measures included curriculum integration and a range in task difficulty. Interpretation: Although most studies reported positive effects of simulation training programs on their outcome measures, definitive conclusions regarding training effectiveness on actual bronchoscopy performance in patients could not be made because of heterogeneity of training features and the sparse evidence of training effectiveness on validated behavioral outcome measures in a patient setting. Trial Registration: PROSPERO; No.: CRD42021262853; URL: https://www.crd.york.ac.uk/prospero/
KW - bronchoscopy
KW - learning
KW - simulation
KW - training
UR - https://www.scopus.com/pages/publications/85169075768
U2 - 10.1016/j.chest.2023.05.012
DO - 10.1016/j.chest.2023.05.012
M3 - Article
C2 - 37178972
SN - 0012-3692
VL - 164
SP - 952
EP - 962
JO - Chest
JF - Chest
IS - 4
ER -
SDG 4 Quality Education