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The following is a summary of “In-situ simulation-based team training reduces incidence of negative events during bronchoscopy. A prospective educational intervention cohort study,” published in the April 2025 issue of Respiratory Research by Clausen et al. 

Although bronchoscopy is generally a safe procedure, complications, while infrequent, can pose significant clinical risks if not promptly and effectively managed. This study aimed to evaluate the impact of an in-situ, case-based bronchoscopy simulation training program, grounded in real-world data, on the frequency and nature of adverse events during bronchoscopic procedures.

A targeted simulation training program was developed following semi-structured interviews with staff from a respiratory bronchoscopy unit. These insights informed the creation of a realistic team-based training scenario designed to enhance clinical responses to procedural complications. The effectiveness of the intervention was assessed using the Kirkpatrick evaluation model. The primary outcome, corresponding to level three of the framework, was the change in procedural behavior as reflected by the rate of adverse events. Secondary outcomes included participant reactions (level one), changes in stress perception (level two), and patient-reported outcomes (level four), all captured through structured questionnaires.

The study included 124 bronchoscopy cases, 61 prior to and 63 following the simulation training. The overall incidence of adverse events significantly decreased from 62% pre-intervention (38/61 cases) to 41% post-intervention (26/63 cases) (p = 0.019). The most common complication was oxygen desaturation to below 90%, which occurred in 34% of procedures before training and only 11% after (p = 0.002). Although participants reported the simulation training as clinically relevant and beneficial, it did not significantly alter their perceived stress levels during procedures. From the patient perspective, there was a notable change in perceived sedation: patients post-intervention reported being less awake during the procedure, with median scores decreasing from 5 (IQR 3–8) to 2 (IQR 1–5) (p = 0.02), suggesting improved procedural comfort and sedation management.

The integration of case-based, in-situ simulation training significantly improved team performance during bronchoscopic procedures by reducing the overall rate and severity of adverse events, particularly hypoxemia. These findings demonstrate the value of simulation-based education in enhancing procedural safety and suggest that such training should be incorporated into standard bronchoscopy training programs. While stress levels among staff remained unchanged, the observed improvements in clinical outcomes and patient experience highlight the broader benefits of adopting structured crisis-response training within pulmonary care settings.

Source: respiratory-research.biomedcentral.com/articles/10.1186/s12931-025-03205-w