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Bronchoscopy Education: New Insights

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Interventions in Pulmonary Medicine

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Abstract

The shift towards competency-oriented education, coupled with the expansion of media and technology are prompting physicians interested in bronchoscopy education to learn, create, collaborate and teach in ways never explored before. Furthermore, the integration into clinical practice of an expanding number of effective and health-enhancing bronchoscopic procedures warrants that educational processes be tailored to help physicians efficiently climb the learning curve towards competence. In this chapter on bronchoscopy education, new insights regarding several elements crucial to the educational process are provided, including views on (1) curricular structure and delivery, (2) how a structured curriculum using a combination of onsite and online materials such as those provided in the Bronchoscopy Education Project might facilitate learning, (3) why assessment tools help guide the educational process to assure procedure-related competency, and (4) how an ethics of teaching justifies the paradigm shift towards using new information delivery systems to enhance content delivery and knowledge acquisition, in addition to medical simulation in order to accelerate technical skill acquisition and prevent patients from suffering the burden of procedure-related education.

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Notes

  1. 1.

    Live transmissions carry many challenges not the least of which are that cases may be selected based on the expectant participants, intraoperative decisions might be made solely on the basis of educational or theatrical need, and the operator may be distracted by questions or other interactions with the audience.

  2. 2.

    See for example, http://simbionix.com/

  3. 3.

    See for example, http://www.orsim.co.nz/, and http://www.anesthesia.utoronto.ca/edu/cme/bronch.htm.

  4. 4.

    A transnational group of educators and agents of change devoted to the dissemination of bronchoscopy-related knowledge.

  5. 5.

    The BEP is a work in progress with materials constantly being added. For more information, visit HONcode certified website at http://www.Bronchoscopy.org and the BronchOrg page on YouTube.

  6. 6.

    For example, video found at: http://www.youtube.com/watch?v=-MP-WdVcCxY

  7. 7.

    Colt HG. Bronchoscopy Lessons. Instructional video pertaining to various aspects of bronchoscopy You Tube (posted 2010): http://www.youtube.com/watch?v=phRv73Ik7fI&feature=related.

  8. 8.

    For example, video found at http://www.youtube.com/watch?v=Z9FdgVx_xrM

  9. 9.

    Certification is defined as a process that provides assurance to the public that a medical specialist has successfully completed an educational program and undergone some type of evaluation, which almost always includes a high-stakes written examination that is designed to test the knowledge, experience, and skills requisite to the provision of high-quality care in that specialty (see ACGME—Accreditation Council for Graduate Medical Education).

  10. 10.

    Low-stakes testing usually does not have pass-fail thresholds or carry significant consequences. Such assessment would be consistent with an educational process that emphases a quest towards professionalism and competency (progress along the learning curve), but does not measure skill or knowledge with significant consequences. A high-stakes assessment, on the other hand, usually carries significant consequences, such as licensure or pass/fail certification.

  11. 11.

    Competency is the ability gained from knowledge and skills, which forms a basis for performance. To be competent means being able to activate and utilize that knowledge when faced with a problem.

  12. 12.

    In medicine, a learning curve, also called an experience curve, applies to a process where performance improves as a function of practice. This curve may be more or less steep depending on the learner’s skill and knowledge, circumstances, experience, and on whether the procedure being learned is new or established. We increasingly tend to differentiate learners into novices, beginners, intermediate learners (also referred to by some as advanced beginners), experienced, and experts, but simpler delineations of beginner, intermediate, and competent practitioner might also be used. Progress along the learning curve usually occurs in steps, with learners remaining, or choosing to remain on a particular plateau that itself may have its occasional dips and peaks.

  13. 13.

    Reliability is defined as the proportion of reproducible data to random noise recorded by the assessment instrument. Using criterion-referenced testing, concrete criteria are established and the individual is challenged to meet them. This explores what proportion of specific content of knowledge and skills the learners know or are able to perform, as opposed to norm-referenced tests that compare an individual’s performance to the performances of a group (see http://www.valparint.com/CRITERIO.HTMreference downloaded May 25, 2012).

  14. 14.

    In other words, the evidence presented to support or refute the interpretation assigned to assessment that can be used for one test administration and is not necessarily applicable to a different test administration (see Downing and Yudkowsky [44], pp. 22–23).

  15. 15.

    While user instructions, checklists, and assessment tools are provided in the Bronchoscopy Education Project Faculty Development Training Manual, they can also be obtained from various professional societies (such as the ASER and WABIP) and at http://www.Bronchoscopy.org

  16. 16.

    Currently Director of clinical/translational research, UCLA Jonsson Comprehensive Cancer Center.

  17. 17.

    Tinsley and Lebak expanded on Vygotsky’s contructivist theories, describing a zone of reflective capacity in which adults increased their ability for critical reflection through feedback, analyses, and evaluation of one another’s work in a collaborative environment (see Lebak K, Tinsley R. Can inquiry and reflection be contagious? Science teachers, students, and action research. J Sci Teach Educ 2010;21:953–70).

  18. 18.

    Fenstermacher and Soltis describe a humanistic teaching approach, whereby teachers strive to impart knowledge within an environment in which learning has personal meaning for the learner. By adopting various teaching techniques; facilitator (coaching), executive (modifying the curriculum based on review of assessment results), or liberationist (fostering discovery and creativity); for example, liberationist educators might alter their teaching methods on the spot according to the medical learning environment and to fit the many different ways individual learners learn (italics are mine).

  19. 19.

    David Ausubel (1918–2008) in his meaningful reception theory where, contrary to rote memorization or discovery learning based on problem-solving, one’s knowledge of new material is enhanced if the material is related to relevant ideas within the learner’s existing cognitive structure (http://tip.psychology.org/ausubel.html, downloaded December 27, 2010).

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Author information

Authors and Affiliations

  1. Department of Pulmonary and Critical Care Medicine, University of California, 101 The City Drive Orange, Irvine, CA, 92868, USA

    Henri G. Colt

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  1. Henri G. Colt
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Correspondence to Henri G. Colt .

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Editors and Affiliations

  1. MD Anderson Cancer Center, Houston, TX, Department of Pulmonary Medicine, Bellvitge University Hospital, Barcelona, 08907, Spain

    Jose Pablo Díaz-Jimenez

  2. Clinica Y Maternidad Colon, Pulmonary Department, Mar Del Plata, Buenos Aires, 7600, Argentina

    Alicia N. Rodriguez

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Colt, H.G. (2013). Bronchoscopy Education: New Insights. In: Díaz-Jimenez, J., Rodriguez, A. (eds) Interventions in Pulmonary Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6009-1_6

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  • DOI: https://doi.org/10.1007/978-1-4614-6009-1_6

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