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- Title
Combined cumulative sum (CUSUM) and chronological environmental analysis as a tool to improve the learning environment for linear-probe endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) trainees: a pilot study.
- Authors
Yasuhiro Norisue; Yasuharu Tokuda; Juarez, Mayrol; Uchimido, Ryo; Shigeki Fujitani; Stoeckel, David A.; Norisue, Yasuhiro; Tokuda, Yasuharu; Fujitani, Shigeki
- Abstract
<bold>Background: </bold>Cumulative sum (CUSUM) analysis can be used to continuously monitor the performance of an individual or process and detect deviations from a preset or standard level of achievement. However, no previous study has evaluated the utility of CUSUM analysis in facilitating timely environmental assessment and interventions to improve performance of linear-probe endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). The aim of this study was to evaluate the usefulness of combined CUSUM and chronological environmental analysis as a tool to improve the learning environment for EBUS-TBNA trainees.<bold>Methods: </bold>This study was an observational chart review. To determine if performance was acceptable, CUSUM analysis was used to track procedural outcomes of trainees in EBUS-TBNA. To investigate chronological changes in the learning environment, multivariate logistic regression analysis was used to compare several indices before and after time points when significant changes occurred in proficiency.<bold>Results: </bold>Presence of an additional attending bronchoscopist was inversely associated with nonproficiency (odds ratio, 0.117; 95% confidence interval, 0-0.749; P = 0.019). Other factors, including presence of an on-site cytopathologist and dose of sedatives used, were not significantly associated with duration of nonproficiency.<bold>Conclusions: </bold>Combined CUSUM and chronological environmental analysis may be useful in hastening interventions that improve performance of EBUS-TBNA.
- Subjects
JAPAN; CUSUM technique; NEEDLE biopsy; BRONCHOSCOPY; LYMPH nodes; PERFORMANCE evaluation; ULTRASONIC imaging; CLINICAL competence; MULTIVARIATE analysis; QUALITY assurance; STATISTICS; LOGISTIC regression analysis; PILOT projects; DATA analysis
- Publication
BMC Pulmonary Medicine, 2017, Vol 17, p1
- ISSN
1471-2466
- Publication type
journal article
- DOI
10.1186/s12890-017-0375-9