• Lars Konge, Henrik Arendrup, Christian von Buchwald, and Charlotte Ringsted.
• Centre for Clinical Education, University of Copenhagen and Capital Region of Denmark.
• J Bronchology Interv Pulmonol. 2011 Jan 1; 18 (1): 38-41.

BackgroundVirtual reality (VR) bronchoscopy simulators have been available for more than a decade, and have been recognized as an important aid in bronchoscopy training. The existing literature has only examined the role of VR simulators in diagnostic bronchoscopy. The aim of this study was to find out whether the simulations of both diagnostic bronchoscopies and more advanced procedures were realistic, and whether clinical experience in bronchoscopy was associated with better and faster performance of basic pulmonary procedures in the simulator.MethodsThirty physicians performed 8 procedures, each on a VR bronchoscopy simulator. They performed 3 diagnostic bronchoscopies, 2 bronchoalveolar lavages, and 3 procedures in which they used all the available biopsy tools (needle, brush, and forceps) that could be used for tumors of increasing procedural difficulty. After the procedures, the physicians answered a questionnaire regarding the realism of the simulator.ResultsThe realism of the anatomy and the appearance of the scope were rated higher than the movement of the scope, feeling of resistance, and performances of bronchoalveolar lavages and biopsies. Overall, the simulator was judged to be realistic and all the physicians agreed that VR bronchoscopy simulation is a good way to learn bronchoscopy. The more experienced physicians performed faster than the less experienced physicians. The simulator feedback did not allow for an assessment of the quality of the performed biopsies.ConclusionsSimulation of performing the procedures was significantly less realistic than the simulation of the anatomy and the scope. It was impossible to use the simulator metrics to assess the quality of the biopsies. Despite these deficiencies, clinicians recommend the use of VR simulators in the teaching of pulmonary procedures.

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