P224 Needle pass time as a metric to monitor progression of EBUS trainees

Background and Objectives Ways to assess and track progress of new EBUS operators and trainees is desirable to ensure training goals and procedural competence are achieved and maintained. While important, relying on the diagnostic yield or on question-based assessments alone is not sufficient. Methods This study examined the longitudinal change in times taken between needle passes (needle pass time; NPT) during EBUS lymph node sampling as a metric to monitor progress. The EBUS database of a tertiary hospital that employs 1–2 lung cancer fellow per year was accessed to extract data on the first 50 EBUS procedures for three trainees were collected. The NPT was derived using PACS images that are stored to document every needle pass during an EBUS procedure and an average NPT per procedure was calculated. Results Between the three trainees 157 procedures were carried out within the study period with 302 LN stations sampled. Station 7 was the most commonly sampled (36.9%). The mean NPT (n=204 stations) was 2:49±0:49 mins. The mean lymph node short axis diameter (n=210) was 15.5±8.7 mm. There was a negative correlation between node size and time per pass (r -0.146, p=0.045). The change in average NPT and time between passes during the study period for the trainees is plotted in figure 1 showing a consistent decrease in average times between passes during the first 50 procedures. A point of ‘convergence’ around the 30th procedure with less variation between procedures was noted (red vertical lines) for the three trainees. On multivariate regression, NPT was significantly associated with procedure order and type of station sampled but not lymph node diameter. Conclusion NPT and time between stations are easy metrics that can potentially help ensure EBUS trainees are advancing in a given training programme.