• Eveline C F Gerretsen, Aoben Chen, Jouke T Annema, Marleen Groenier, van der HeijdenErik H F MEHFMDepartment of Respiratory Medicine, Radboudumc, Nijmegen, The Netherlands., van MookWalther N K AWNKADepartment of Educational Development and Research, School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands; Department of Intensive Care, Maastricht University Medical Center+, Maastricht,, and SmeenkFrank W J MFWJMDepartment of Educational Development and Research, School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands; Department of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands..
• Department of Educational Development and Research, School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands. Electronic address: e.gerretsen@maastrichtuniversity.nl.
• Chest. 2023 Oct 1; 164 (4): 952962952-962.

BackgroundThe implementation of simulation-based training (SBT) to teach flexible bronchoscopy (FB) skills to novice trainees has increased during the last decade. However, it is unknown whether SBT is effective to teach FB to novices and which instructional features contribute to training effectiveness.Research QuestionHow effective is FB SBT and which instructional features contribute to training effectiveness?Study Design And MethodsWe searched Embase, PubMed, Scopus, and Web of Science for articles on FB SBT for novice trainees, considering all available literature until November 10, 2022. We assessed methodological quality of included studies using a modified version of the Medical Education Research Study Quality Instrument, evaluated risk of bias with relevant tools depending on study design, assessed instructional features, and intended to correlate instructional features to outcome measures.ResultsWe identified 14 studies from an initial pool of 544 studies. Eleven studies reported positive effects of FB SBT on most of their outcome measures. However, risk of bias was moderate or high in eight studies, and only six studies were of high quality (modified Medical Education Research Study Quality Instrument score ≥ 12.5). Moreover, instructional features and outcome measures varied highly across studies, and only four studies evaluated intervention effects on behavioral outcome measures in the patient setting. All of the simulation training programs in studies with the highest methodological quality and most relevant outcome measures included curriculum integration and a range in task difficulty.InterpretationAlthough most studies reported positive effects of simulation training programs on their outcome measures, definitive conclusions regarding training effectiveness on actual bronchoscopy performance in patients could not be made because of heterogeneity of training features and the sparse evidence of training effectiveness on validated behavioral outcome measures in a patient setting.Trial RegistrationPROSPERO; No.: CRD42021262853; URL: https://www.crd.york.ac.uk/prospero/.Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

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