Educating the Next Generation of Pulmonary Fellows in Transbronchial Needle Aspiration. Leading the Blind to See

Abstract

Transbronchial needle aspiration (TBNA) remains an invaluable diagnostic tool in the evaluation of mediastinal and hilar abnormalities, specifically in the evaluation of patients with lung cancer. Training in TBNA has remained integral in pulmonary fellowship programs, but unfortunately the training methods, volumes, and outcomes have been variable. This has subsequently led to wide variations in practice patterns, diagnostic yield, and operator confidence. The introduction of endobronchial ultrasound-guided TBNA appears to have stimulated a resurgence in training and performance of TBNA. However, with this new technology, many questions have surfaced regarding training methods, volumes, and who should receive training. Within this context, we describe the history, current state, and future directions of the education of TBNA during pulmonary fellowship training.

Training in interventional pulmonology: the European and US perspective

“…However, the use of cadaver models does present considerable limitations, essentially in that they are incapable of reproducing the exact situation or the complications of a living being, such as the movements of the cardiorespiratory system, coughing, muscle spasm and haemorrhage. Furthermore, depending on the location, the donor may have been required to have given their consent when still alive, and the procedure on cadaver material can only be performed in specifically authorised centres [33,34].…”