Background Prior studies in pulmonology have examined the validity of procedural training tools, however, translation of simulation skill acquisition into real world competency remains understudied. We examine an assessment process with a simulation training course for electromagnetic navigational (EMN) bronchoscopy and percutaneous transthoracic needle aspiration (PTTNA). Methods A cohort study was conducted by subjects using EMN bronchoscopy and PTTNA. A procedural assessment tool was developed to measure basic competency for EMN bronchoscopy and PTTNA at three different time points: first simulation case, final simulation case upon reaching a competent score, and at their first live case. The assessment tool was divided into four domains (total score 4–16, competency ≥ 12) with each domain requiring a passing score (1–4, competency ≥ 3.0). Complication, and procedural time were collected during their first live case. Results Twenty-two serial procedures (12 EMN bronchoscopies, 10 EMN PTTNA) were observed by fourteen subjects. The mean first simulation score for EMN bronchoscopy (4.66 ±0.89) improved after cadaver simulation (12.67 ±0.89, median 3 simulations attempts). The subjects’ mean score for their first live case was 13.0 ±0.85 (self-reported score 12.5 ±1.07). For EMN PTTNA, the mean first simulation score (4.3 ±2.40) improved after cadaver simulation (12.6 ±1.51, median 3 simulation attempts). The subjects’ mean score for their first live PTTNA case was 12.5 ±2.87 (self-reported score 12.1 ±1.05). There was only one minor complication. Conclusion Learning EMN bronchoscopy/PTTNA is feasible using a structured simulation course with an assessment tool.

Pulmonary fellows and practitioners we surveyed preferred a traditional course structure with cadaver/animal models and high-fidelity simulation training as compared with a flipped classroom model and low-fidelity simulators, but whether this holds true for the wider population is unknown. Larger studies are needed to validate learning perception with outcomes.

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