Standardizing education in interventional pulmonology in the midst of technological change

Abstract

Interventional pulmonology (IP) is a maturing subspecialty of pulmonary medicine. The robust innovation in technology demands standardization in IP training with both disease and technology driven training. Simulation based training should be considered a part of IP training as seen in other procedural and surgical subspecialties. Procedure volume is a component of training; however, this does not guarantee or translate into competency for learners. Basic competency skills can be assessed using standardized well validated assessment tools designed for various IP procedures including flexible bronchoscopy, endobronchial ultrasound guided transbronchial needle aspiration (EBUS TBNA), rigid bronchoscopy and chest tube placement; however, further work is needed to validate tools in all procedures as new technologies are introduced beyond fellowship training. Currently there are at least 39 IP fellowship programs in the United States (US) and Canada which has led to improved training by accreditation of programs who meet rigorous requirements of standardized curriculum and procedural volume. The challenge is to be innovative in how we teach globally with intention and how to best integrate new evolving technology training for those not only during fellowship training but also beyond fellowship training.

Training in interventional pulmonology: a leap into the future

“…To address these challenges, the Association of Interventional Pulmonary Program Directors (AIPPD) has initiated a grant application process, enabling programs to solicit support components vital for program operations. Fostering faculty development unique to this subspecialty is crucial for augmenting educational practices and principles, effectively mentoring and guiding trainees toward attaining proficiency and excellence in procedural skills and cognitive knowledge, translating these skills to bedside care for ensuring well tolerated and high-quality care, requires deliberate practice underscored by developed content, clear objectives, and expected deliverables [1 ▪ ,6 ▪ ]. The AIPPD continues to provide resources with faculty development programs for program directors.…”

“…Awareness of both the educator and learner of the growth from novice to basic competency requiring ongoing deliberate practice with escalating elements of complexity is required to prevent both arrested development and skill decay (Fig. 1) [6 ▪ ,7]. Furthermore, these advancements are eliminating geographic limitations, particularly evident in evolution of augmented reality applications for procedural training.…”

Innovation in rigid bronchoscopy—past, present, and future

“…The role of simulation training specific to RB using mannequin and cadaver models has continued to improve the educational training of both trainees and physicians seeking to gain knowledge and competency in RB ( 71 ).…”

Interventional bronchoscopy for HPV 16 and 66 with the use of spraying interferon-α (2b) plus bevacizumab and anti-reflux agent

“…In the case of bulky disease interventional bronchoscopy is the solution for bulky endobronchial disease [ 7 ]. We can use mild sedation with fiber optic bronchoscopes or general anesthesia with rigid bronchoscopes [ 8 ]. Jet-ventilation is the optimal mode of ventilation [ 7 , 9 ].…”