Evaluation of a bronchoscopy guidance system for bronchoscopy training, a randomized controlled trial

BACKGROUND: Conventional training in bronchoscopy is performed either on patients (apprenticeship model) or phantoms. While the former is associated with increased rate of patient complications, procedure time, and amount of sedation, the latter does not offer any form of feedback to the trainee. This paper presents a study which investigates whether a bronchoscopy guidance system may be a helpful tool for training of novice bronchoscopists. METHODS: A randomized controlled study with 48 medical students was carried out with two different groups (control and test group, each N = 24). Whereas the control group performed a conventional bronchoscopy on phantom the test group carried out an Electromagnetic Navigation Bronchoscopy (ENB) for tracking of the bronchoscopal tip in the bronchial system. All volunteers had a common task: to perform a complete and systematic diagnostic bronchoscopy within 10 min. RESULTS: The test group examined significantly more lobes than the control group (p = 0.009). Due to the real-time feedback of the system, all students of test group felt more confident having analyzed the entire lung. Additionally, they were unanimous that the system would be helpful during the next bronchoscopy. CONCLUSIONS: In sum, this technology may play a major role in unsupervised learning by improving accuracy, dexterity but above all by increasing the confidence of novices, students as well as physicians. Due to good acceptance, there may be a great potential of this tool in clinical routine.