PRECLINICAL TRAINING IN ENDOSCOPIC DIAGNOSIS OF CANCER

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One goal of this project is to assess the effects of incorporating a preclinical viewing session of five videotape programs in bronchoscopic anatomy and pathology into the physicians' bronchoscopic training phase. The videotape programs include a systematic approach to endoscopic anatomy and examples of endoscopic pathology that should facilitate the development of visual discrimination skills. Seventy residents/fellows from ten University Medical Centers have taken part in this randomized study. The residents were divided into two groups--the control groups, who did not observe the programs, and the test group who did observe the programs, prior to their tenth bronchoscopy. Preliminary statistical analysis has indicated a positive effect of these programs on the test group. The videotape programs that describe endoscopic features associated with chronic irritation, cancer-related conditions, and early carcinoma of the esophagus have been produced. They are designed to teach beginning esophagoscopists the endocopic features that may help in the detection and diagnosis of early esophageal carcinoma. Early detection of carcinoma should hopefully lead to more effective treatment and a reduced mortality rate. Thus far, these two programs have won six national awards for medical, educational, and technical value. Four videotape programs are in the final stages of completion. Two programs in anatomy demonstrate a method for recognizing and naming sub-segmental bronchi of the right and left lung, so that pathological findings can be readily correlated with their respective anatomical locations. Two other programs include a series of bronchoscopic case study examples that are designed to provide a self-assessment in anatomy and pathology for the beginning or practicing bronchoscopist, and one of these could be used for pre-post test application. (5)