P36 Ebus-tbna diagnostic yield can be maintained when performed by a trainer supervising a second operator trainee

Introduction Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) facilitates diagnosis of hilar and mediastinal lymphadenopathy. The procedure usually requires two operators; one guiding the bronchoscope and other undertaking needling for biopsy. British Thoracic Society Quality Standards recommend a diagnostic yield of 88%. Increased training and experience has been shown to improve diagnostic yield over time. 1 Services face a potential conflict between delivering a high quality service, as evidenced by high diagnostic yield, and training specialty registrars. Our EBUS-TBNA trainers have trained 35 trainees since 2011. We evaluated EBUS diagnostic yield at a tertiary centre with procedures carried out by trainer and trainee operators. Methods Retrospective analysis of two operator EBUS-TBNA procedures from March 2011 to December 2016 was carried out. Data was collected on gender, age, procedure date and clinicians involved in the procedure. Overall diagnostic yields were calculated for trainers compared to trainees for both manoeuvring the bronchoscope and needling. Diagnostic rates according to year of EBUS-TBNA for trainers vs trainees were also calculated. Mann-Whitney U test was used to check for differences in hit-rates for trainers vs trainees between the two components of the procedure, whilst Kruskal Wallis test was used to assess difference in diagnostic yield between 2011–2016. Results 1083 patients underwent EBUS-TBNA with mean age 61 years (SD +/-14), 464 (43%) were female. The overall diagnostic rate was 88%, with 479 (44%) malignant, 212 (20%) granulomatous, 262 (24%) benign and 130 (12%) non-diagnostic. Trainees manoeuvred the bronchoscope for 577 (53%) and needled for 461 (43%) patients. There were no differences in diagnostic yields between trainers compared to trainees for manoeuvring [88% vs 88% (p=0.81)] nor for needling [88% vs 88% (p=0.84). There were also no significant differences in diagnostic yield between years (figure1). Conclusion In our institution we can teach multiple trainees whilst maintaining high diagnostic yield in two operator EBUS-TBNA for both manoeuvring the bronchoscope and needling when one operator is fully trained. Reference Fuso, et al . Influence of the learning effect on the diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal and hilar lymph nodes. Journal of Bronchology u0026 Interventional Pulmonology 2017;24(3):193–199.