A survey of training in pediatric flexible bronchoscopy.

OBJECTIVE: There is currently no evidence-based method for defining competency in pediatric flexible bronchoscopy (FB). Based on expert opinion, guidelines using numbers of procedures have been published in defining competency for pediatric FB. The purpose of this study was to formally survey the opinion of USA pediatric pulmonology training directors about the assessment of competency and training experiences in pediatric FB in their programs.

METHODS: An Internet-based Survey Monkey™ of the Pediatric Pulmonary Training Directors Association (PEPTDA) was administered 10/12/10 through 11/1/10 with a supplemental survey 6/1/11-6/30/11.

RESULTS: This survey of US pediatric pulmonology training directors about competency and training in pediatric FB showed that a majority (86%) felt there was a minimum threshold of procedures for developing competency that could be defined, with a median of 50 and an average of 56.4 (SD = 33.0). The actual number of FBs performed by fellows during their 3-year fellowship averaged 89.4 (SD = 45.3) with a range of 10-200. The survey also revealed a variety of teaching techniques used for FB, including simulation technology. Finally many differences were reported in skill assessment, locations for performance of FB, and the range of underlying indications and patient populations. The apprenticeship model is the predominant method of learning FB in the surveyed programs.

CONCLUSIONS: A majority of US pediatric pulmonology training directors felt that a minimum number of procedures could be defined for developing competency in pediatric FB. There was variability in the numbers of procedures performed, training techniques and assessment, and application of FB. This survey represents an initial step in assessing training and defining competency in pediatric FB.