Procedural Training in Canadian Respirology Programs: A Survey of Residents and Program Directors

BACKGROUND: A prior survey of procedural exposure in Canadian respirology programs revealed insufficient exposure for complex procedures. Since then, competence-based education was implemented, and shifts in practice may have impacted procedural training. OBJECTIVE: This study aimed to determine the current state of procedural training in Canadian adult respirology residency programs. METHODS: A web-based survey was sent by email to the 15 Canadian adult respirology program directors (PDs), who transferred the survey to PGY4, PGY5 residents, and first-year graduates (as of June 2023). Procedural volumes, learning and assessment methods, and residents' perspectives were assessed. PDs were also invited to complete a survey. RESULTS: Forty-four residents completed the survey (37% response), and 16 PDs or assistant PDs completed the survey. Procedural volumes were variable. The proportion of residents who agreed or strongly agreed to receiving adequate training was 98% for bronchoscopy, 53% for transbronchial biopsy, 37% for foreign body removal, 93% for thoracentesis, and 63% for chest drain insertion. PGY5s and first-year graduates agreed or strongly agreed with feeling confident to perform procedures independently in a proportion of 100% for bronchoscopy, 100% for thoracentesis, 73% for transbronchial biopsy, 53% for foreign body removal, and 67% for drain insertion. Access to longitudinal simulation is not universal, particularly for pleural procedures. The use of validated assessment tools is infrequent, and procedural outcomes are not tracked by residents or programs consistently. CONCLUSIONS: Canadian respirology residents and PDs report variable procedural exposure, learning methods, and assessment methods. The results highlight possible areas for improvement in procedural training.