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Linear Endobronchial Ultrasonography: Where Do General Pulmonary Fellows Stand?
Procedures SESSION TITLE: Unique Investigations in Interventional Pulmonology SESSION TYPE: Original Investigation Slide PRESENTED ON: Tuesday, October 25, 2016 at 02:45 PM - 04:15 PM
Linear Endobronchial Ultrasonography: Where Do General Pulmonary Fellows Stand? Majid Shafiq MD*; and Arthur Sung MD Stanford University, Stanford, CA PURPOSE: Linear endobronchial ultrasonography (EBUS) enables the bronchoscopist to diagnose and stage lung cancer at the same time, offering an effective and safer alternative to surgery up to 90% of the time. With the advent of low-dose CT (LDCT) screening since 2015, EBUS procedures are poised to increase further and require more competent providers to fulfill this need. We surveyed EBUS experts and thought-leaders about the current and future prospects of attaining EBUS competency during a general pulmonary fellowship and their attitudes toward bringing EBUS into a general pulmonologist’s armamentarium. METHODS: An anonymous survey was distributed to members of American Association for Bronchology and Interventional Pulmonology, the flagship organization of interventional pulmonology with a membership base in United States and Canada. Respondents were asked about their training and clinical practice, EBUS competence of their current fellows, and views on attaining EBUS competence. RESULTS: Out of 181 respondents, 77% reported teaching or supervising linear EBUS procedures directly. Among those, a majority (58%) supported training general pulmonary fellows for independent practice. Most (61%) believed that their fellows adequately understood EBUS indications and 63% were satisfied with fellows’ understanding of lung cancer staging, but only 34% felt their fellows were technically competent in EBUS. The most highly ranked educational tool was supervised practice on real patients, while over 65% cited 25-50 procedures as the minimum number needed to attain competence. Forty-three percent reported having completed formal training in interventional pulmonology. This subgroup was less likely to support training general pulmonary fellows for independent practice (p¼0.06).
PROCEDURES
CONCLUSIONS: Our findings support a paradigm shift in terms of bringing linear EBUS competence into ACGME requirements for a general pulmonary fellowship. Presently, most general pulmonary fellows are not fit for independent EBUS practice post-fellowship. However, the minimum requirements cited for competence are achievable during fellowship, especially as institutional case numbers increase in the post-LDCT era. Most EBUS teachers support training general pulmonary fellows for independent practice, ranking supervised practice on real patients as the most important training tool. CLINICAL IMPLICATIONS: Shaping general pulmonary fellowship curricula to ensure attainment of competence in the theory and practice of EBUS will help to address the large and increasing need for linear EBUS in the LDCT era. DISCLOSURE: The following authors have nothing to disclose: Majid Shafiq, Arthur Sung No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.08.1150
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
1044A
[
150#4S CHEST OCTOBER 2016
]
Linear Endobronchial Ultrasonography: Where Do General Pulmonary Fellows Stand? Majid Shafiq MD*; and Arthur Sung MD Stanford University, Stanford, CA PURPOSE: Linear endobronchial ultrasonography (EBUS) enables the bronchoscopist to diagnose and stage lung cancer at the same time, offering an effective and safer alternative to surgery up to 90% of the time. With the advent of low-dose CT (LDCT) screening since 2015, EBUS procedures are poised to increase further and require more competent providers to fulfill this need. We surveyed EBUS experts and thought-leaders about the current and future prospects of attaining EBUS competency during a general pulmonary fellowship and their attitudes toward bringing EBUS into a general pulmonologist’s armamentarium. METHODS: An anonymous survey was distributed to members of American Association for Bronchology and Interventional Pulmonology, the flagship organization of interventional pulmonology with a membership base in United States and Canada. Respondents were asked about their training and clinical practice, EBUS competence of their current fellows, and views on attaining EBUS competence. RESULTS: Out of 181 respondents, 77% reported teaching or supervising linear EBUS procedures directly. Among those, a majority (58%) supported training general pulmonary fellows for independent practice. Most (61%) believed that their fellows adequately understood EBUS indications and 63% were satisfied with fellows’ understanding of lung cancer staging, but only 34% felt their fellows were technically competent in EBUS. The most highly ranked educational tool was supervised practice on real patients, while over 65% cited 25-50 procedures as the minimum number needed to attain competence. Forty-three percent reported having completed formal training in interventional pulmonology. This subgroup was less likely to support training general pulmonary fellows for independent practice (p¼0.06).
PROCEDURES
CONCLUSIONS: Our findings support a paradigm shift in terms of bringing linear EBUS competence into ACGME requirements for a general pulmonary fellowship. Presently, most general pulmonary fellows are not fit for independent EBUS practice post-fellowship. However, the minimum requirements cited for competence are achievable during fellowship, especially as institutional case numbers increase in the post-LDCT era. Most EBUS teachers support training general pulmonary fellows for independent practice, ranking supervised practice on real patients as the most important training tool. CLINICAL IMPLICATIONS: Shaping general pulmonary fellowship curricula to ensure attainment of competence in the theory and practice of EBUS will help to address the large and increasing need for linear EBUS in the LDCT era. DISCLOSURE: The following authors have nothing to disclose: Majid Shafiq, Arthur Sung No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.08.1150
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
1044A
[
150#4S CHEST OCTOBER 2016
]