What is The Practical Approach to Interventional Bronchoscopy©

The Practical Approach© is an interactive learning program designed to complement the traditional apprenticeship model of learning:

  • The purpose of The Practical Approach to Interventional Bronchoscopy© is help learners gain the cognitive, technical, affective, and experiential, skills necessary to perform minimally invasive bronchoscopic procedures in a patient/family focused-care environment. Competency is sought in the three major elements of a procedure; strategy and planning, execution, and response to procedure-related adverse events or complications.

  • Using a four box approach inspired from Albert Jonsen's1 classic work in medical ethics, learners rationalize various components of the decision making process.
  • By working through case scenarios, learners are prompted to think about the how and why of their actions, based on background information, pertinent literature, and experience. Case examples are provided on line, and a blank Practical Approach template can be downloaded and completed for presentations and communications with an instructor or class.
  • Consistent with the ACGME professionalism competency guides2,3, case scenarios also prompt learners to address various components of the Informed Consent process, and outcomes based on possible as well as real results.

Initial Evaluation

  1. Physical examination, complementary tests, and functional status assessment
  2. Patient’s significant comorbidities
  3. Patient’s support system (also includes family)
  4. Patient preferences and expectations (also includes family)


Procedural Strategies

  1. Indications, contraindications, and expected results
  2. Operator and team experience and expertise
  3. Risk-benefits analysis and therapeutic alternatives
  4. Respect for persons (Informed Consent)


Procedural Techniques and Results

  1. Anesthesia and other perioperative care
  2. Techniques and instrumentation
  3. Anatomic dangers and other risks
  4. Results and procedure-related complications

Long term Management Plan

  1. Outcome assessment
  2. Follow-up tests, visits, and procedures
  3. Referrals to medical, surgical, or palliative/end of life subspecialty care
  4. Quality improvement and team evaluation of clinical encounter


The Practical Approach to Interventional Bronchoscopy© is also a collection of PowerPoint slide presentations to help learners achieve technical proficiency. Current recommendations set forth by the American College of Graduate Medical Education4 are followed whereby trainees learn to:

  • Gather essential and accurate information about their patients.
  • Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence and clinical judgment.
  • Use information technology to support patient care decisions and patient education.
  • Develop patient management plans.
  • Counsel and educate patients and their families.
  • Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families.
  • Provide health care services aimed at preventing health problems or maintaining health.
  • Work with health care professionals, including those from other disciplines, to provide patient-focused care.
  • References:
    1. Jonsen AR, Siegler M, Winslade WJ. Clinical Ethics. 6th Ed, McGraw Hill, NY 2006.
    2. ACGME Web site: http://www.acgme.org/outcome/comp/compfull.asp
    3. Apelgren K. ACGME e-Bulletin. August 2006
    4. ACGME Competencies at http://www.acgme.org

If you have a presentation you would like to have included in The Practical Approach© collection, please contact us at BI@Bronchoscopy.org.

If you would like to translate a presentation from The Practical Approach© collection, please feel free to do so. We would highly appreciate receiving a copy of the translated version.

If you would like to use any of the information from The Practical Approach© collection in a training program, during lectures, or for research purposes, please feel free to do so. In case of publication or presentations, we would appreciate it if you would cite these as follows:

Bronchoscopy International: The Practical Approach©, an Electronic On-Line Multimedia Slide Presentation. http://www.Bronchoscopy.org/Practical Approach. Published 2007 (Please add “Date Accessed”).

To learn more about The Practical Approach©, please watch the PowerPoint presentation The Practical Approach© or simply begin with part 1.