HomeProfessionalsCareer DevelopmentFellowsInnovations in Fellowship Education2017 ▶ An Interactive, Flipped-Classroom Approach to Introducing Pulmonary Fellows to Flexible Bronchoscopy
An Interactive, Flipped-Classroom Approach to Introducing Pulmonary Fellows to Flexible Bronchoscopy

Boston University

Boston, MA

Abstract Authors: David Chiasiang Chu, MD and Christine Campbell Reardon, MD

Program Director: Christine Campbell Reardon, MD

Type of Program: Pulmonary/Critical Care


Flexible bronchoscopy is an essential skill for pulmonary fellows to master over the course of fellowship. In many programs, there is an orientation that includes an introduction to bronchoscopy. However, the amount of instruction and hands-on experience that fellows receive prior to performing clinical bronchoscopies is often very limited. Additionally, information obtained in the course of performing clinical bronchoscopies may be variable. In order to prepare our fellows to perform bronchoscopy prior to performing the procedure in live patients, and to standardize the information they received, we developed an interactive, flipped classroom and simulation-based curriculum to introduce flexible bronchoscopy to pulmonary fellows.


We performed a needs assessment of current pulmonary fellows and faculty about the familiarity and comfort of fellows with bronchoscopy topics and procedural skills. Based on the results of this survey, we created a curriculum of relevant bronchoscopy topics to provide more hands-on training early in the first year of training. Our curriculum included a half-day orientation, consisting of a 30-minute didactic session followed by bronchoscopy practice on plastic models and with a high-fidelity virtual reality (VR) simulator. Fellows were instructed to complete 15 VR bronchoscopies using the simulator within the first 3 months of training. Additionally, over the first month of training, fellows participated in three 1-hour sessions in a flipped-classroom format covering general bronchoscopy topics. Prior to these sessions, fellows were provided with 2-3 page outlines of bronchoscopy topics we created based on a current review of the literature. Each session was facilitated by a faculty member, using a PowerPoint presentation and notes we created to guide key teaching points. The sessions began with questions based on the provided outlines to assess if fellows had reviewed the material. Then, the fellows participated in a case-based group discussion about management decisions focused on the topics assigned for each session.


In this ongoing study, 6 first-year fellows were assessed at the start of orientation using the APCCMPD novice bronchoscopy cognitive test to establish their baseline level of knowledge. Repeat assessment is planned after 12 months of clinical rotations to determine the long-term retention of information following participation in the curriculum. Their scores will be compared to the scores of fellows (N=6) who completed their first year of training prior to implementation of the introductory curriculum. Additionally, fellows will be surveyed on their perceptions of the utility of the sessions, training materials and self-directed practice with VR bronchoscopy.


We have created an interactive flipped classroom and simulation-based curriculum to cover bronchoscopy topics early in fellowship training. Our innovation lies in both the creation of quick reference materials for fellows to use when planning and performing bronchoscopy, and in the introduction of this information in an interactive format. This curriculum was created to be self-contained and would require little preparation to implement at other institutions.