University of Michigan Hospitals Pulmonary/Critical Care Fellowship

Bronchoscopy Learning Objectives

 

Goals

 

  1. To gain proficiency in the use and performance of bronchoscopy and thoracentesis as diagnostic and therapeutic tools.

 

Objectives

 

I. Medical Knowledge

 

  1. Gain knowledge in lung and chest cavity anatomy in both normal and diseased states.
  2. Identify the indications, complications and likelihood of successful outcome in performing bronchoscopy and thoracentesis.
  3. Gain knowledge in the pharmacology of analgesics, sedatives and anticholinergics.

 

II. Patient Care

  1. Become familiar with the operation of a fiberoptic bronchoscope, supporting equipment and fluoroscope.
  2. Become proficient in the following bronchoscopic procedures:
    1. Endotracheal intubation
    2. Airway examination
    3. Bronchoalveolar Lavage
    4. Bronchial brushing and washing
    5. Endobronchial forceps biopsy
    6. Transbronchial forceps biopsy
    7. Transbronchial needle aspiration and core biopsies (Wang needle aspiration)
    8. Foreign body removal
  3. Become proficient at performing diagnostic and therapeutic thoracentesis.
  4. Learn to manage complications of bronchoscopy and thoracentesis including bleeding, pneumothorax and respiratory failure.
  5. Become proficient in the proper use of analgesics, sedatives and anticholinergics, and in managing the complications of conscious sedation.

 

III. Practice-Based Learning and Improvement

 

1.       Improve procedural practices by following up on test results in order to identify methods of optimizing yield and to identify special circumstances that alter yield and risks.

2.       Improve patient care practices through education of patients and families on the indications, usual risks and complications and meaning of results when procedures are performed.

3.       Improve teaching skills by educating and supervising housestaff on the performance of procedures.

                    

IV. Systems-based Practice

 

1.        Become proficient at appropriately selecting the sampling methods and diagnostic studies to optimize yield.

2.        Become proficient in managing a large, busy procedural unit.  This includes managing nurses and technicians, patient flow and specimen collection, handling and transport.

3.        Learn appropriate procedural techniques to ensure patient safety.

 

V. Professionalism

 

  1. Demonstrate effective communication skills in interactions with procedure unit staff, nurses, and respiratory therapists.
  2. Demonstrate effective communication with patients in delivering healthcare, and planning appropriate follow-up after procedures.
  3. Demonstrate respect for patient privacy, autonomy and awareness during conscious sedation.
  4. Acknowledgement of errors and limitations

 

VI. Interpersonal Communication Skills

 

  1. Communicate respectfully and effectively with staff, nurses and technicians in procedural units.
  2. Maintain comprehensive, timely, and effective procedure documentation.
  3. Act in a consultative role to other physicians and effectively communicate procedure results to the appropriate care-takers.