A New Milestone-2000 Users!

We’re communicating in real-time and we are up to 2000 users from 32 different countries. I monitor all these accounts 24 hours a day, seven days a week, and I can truly say that the information exchange and case presentations are fascinating!

The only problem is the WhatsApp platform has decreased performance because of changes WhatsApp has made to its user platform, presumably to decrease spam. For those of you wondering why you are not seeing as many redirects, it is because I am limited to only five redirects at a time, making redirects burdensome and time-consuming. Still, my impression is that our communications are beneficial to many countries and regions, as well as to groups such as our pediatrics group and South American IP group. 

Many physicians communicate in their natural languages rather than English. In these cases, I translate information before redirecting educational materials and interesting cases, Feedback from redirects have proven to be helpful, and in many cases change patient management. Thank you to all who contribute cases and opinions!

So where do we go from here, now that we have reached the 2000 users milestone? Many countries still have only a few users. Perhaps the admins for these groups can recruit new users? I am interested in knowing why colleagues are not eager to join your WhatsApp group and exchange information. 

For those groups with many users (anywhere from 50-250), please remember how helpful it is when you add references, scientific articles and other “evidence” to help support opinions. Also, remember that videos are most effective when they are short and edited. Same goes for photos (better to use one photo that combines other images, than four different photographs).

Stay tuned for more information on greenapplecleaningmd.com/ how we can increase our global communication efforts, and again, congratulations to everyone for reaching the milestone of 2000 users, which benefits patients around the world.

Please subscribe to Colt’s Corner to automatically receive an email notification of future posts. Sign up with your name and email on the NEWSLETTER button on the Bronchology International home page at  www.bronchoscopy.org.

World lung cancer day

August 1 is World Lung Cancer Day.

According to the World Health Organization, there were 2.09 million lung cancer cases in 2018 and 1.76 million deaths. Almost everywhere, 5-year survival is less than 20 percent. Despite spending millions of dollars, making advances in molecular biology, immunology, and genetics-related research, building knowledge of cancer epidemiology, improving health care facilities, studying early detection, and raising awareness among the general public about the risks of tobacco use and exposures to environmental and other risk factors, there is still no cure.

Worldwide, lung cancer occurs more frequently than other diseases such as colorectal cancers, liver, stomach, breast or even non-melanoma skin cancers.  In men, lung cancer is a significant cause of death; greater than either prostate or colorectal cancer. In women, it is a greater cause of death than either breast, or colorectal cancer. In fact, for both men and women, one out of every four cancer deaths is from lung cancer.

And this is not a disease that spares countries, although frequencies in men and women vary. For example, recent statistics suggest that Hungary, Serbia, and Korea lead the lung cancer frequency field for men, whereas Denmark, Canada, and the United States lead the field for women. We must also be aware that cancer outcomes differ according to socioeconomic status. In many countries, research shows that racial and ethnic minorities receive lower-quality care. 

Tobacco has a causal relationship with lung cancer, as do second-hand smoke exposure, exposure to certain environmental and chemical risk factors such as radioactive ores, radon, diesel gas, certain inhaled chemicals and minerals, and even arsenic in drinking water. Some believe there is a genetic predisposition to lung cancer; risks are increased in case of family members with a history of the disease. Studies are needed to elucidate whether this is from genetic, environmental or lifestyle-related commonalities. 

Another well-known environmental risk for lung cancer is asbestos, which also causes malignant pleural mesothelioma. I was recently climbing in New Caledonia, an island of about 300,000 people (with more than 100 tribes in 33 communes) in the Southwest Pacific Ocean. According to statistics, this French collectivity is surprisingly high on the list of countries with a preponderance of lung cancer (possibly associated with local asbestos exposures).

Interventional pulmonologists dedicate much of their energy to helping diagnose and treat patients with lung cancer. While significant advances have been made, a certain therapeutic nihilism is still seen in many countries. Eliminating such a mindset everywhere would be a marvelous step toward eradicating this terrible disease.

Please subscribe to Colt’s Corner to automatically receive an email notification of future posts. Sign up with your name and email on the NEWSLETTER button on the Bronchology International home page at  www.bronchoscopy.org.

More action, less words

Imagine a hands-on experience where experts work with small groups of learners instead of the traditional “pre-conference workshop” followed by hours of lectures.

We did this at the recent Asian Pacific meeting held in Australia under the leadership of Dr. David Fielding, and again at a bronchoscopy course led by Dr. Javier Flandes in Spain. Feedback was positive and encouraging. In the next paragraphs, I will identify just a few advantages and disadvantages of such conference strategies.

Advantages: (1) People learn something. Active engagement time is maximized by using predetermined learning objectives and focused hands-on training with a low teacher/student ratio (one instructor for less than five learners). Teachers identify weaknesses by incorporating checklists and assessment tools into workstations. Learners reinforce skills they already have and identify areas they need to work on.  (2) Keeping didactic lectures to 10 minutes forces speakers to improve communication skills. They focus on what is truly important and not necessarily learned by reading. A short didactics program forces organizers to identify core competencies and prompts speakers to give lectures that are complementary rather than all-encompassing. Didactics are modifiable based on audience needs (learner-centricity). (3) Workshops enhance exposure to a variety of technologies, instruments, and teaching techniques. To find the best work injury lawyer los angeles, CA visit http://lacaccidentpros.org site. Companies see users get their hands on their equipment. Learners prefer doing to listening. Simulation using models, computers, and role-playing exercises forces teachers to learn how to use specific scenarios. This skill is essential for tomorrow’s educators today.

Disadvantages: (1) People are resistant to change, despite statistics showing the value of short lectures. Materials can be provided before or on-site in the form of on-line PDF files or presentations. (2) Organizers must work to organize workshop style formats.They must carefully select instructors and assignments. This bruises egos. Course directors might need to learn how to organize such programs and how to assess value. Instructors might need to improve small-group teaching skills. Expect resistance for the same reasons as above. (3) Not all topics can be covered, although special lectures, pro/con debates and interactive panel discussions for controversial issues and new technologies are warranted.

We are a technology and empathy-driven profession where actions speak louder than words.

Please subscribe to Colt’s Corner to automatically receive email notification of future posts. Sign up with your name and email on the NEWSLETTER button on the Bronchology International home page at  www.bronchoscopy.org.

In Mourning: Viktor Sokolov

In 1826, The Russian poet Alexander Pushkin wrote “But with the truth he attracted hearts. But with science he quelled mores.” (From, Stanzas). Such words could be used to describe the life and work of my friend Professor Viktor Sokolov (1946-2019), who died last month at the young age of 73.

Viktor was an accomplished surgeon, anesthesiologist and bronchoscopist. He created the Russian Bronchology Group and was the first Russian regent to the WABIP. He fought to defeat conventional wisdoms and dedicated his life to modernize bronchoscopy practice in his country. In addition to numerous leadership positions, Professor Sokolov was also a former Chair for the Endoscopy Commission of the Russian Ministry of Health, and a long time member of the Academic Council.  

As department head at the Moscow Research institute he led efforts to perform novel interventions in patients with early cancer of the larynx, trachea and bronchi, esophagus, stomach and duodenum, bile duct, choledochus, rectum and colon. He helped promote the use of electrosurgery, argon plasma coagulation, laser thermal destruction, photodynamic therapy and stent insertion. He published more than 300 original scientific papers, dozens of monographs, clinical care guidelines, and 10 teaching manuals. He held 26 patents for scientific methodologies and instruments. 

For more than ten years, I corresponded frequently with Viktor and his son Dmitry (also an expert bronchoscopist). It was a great honor to help them build a training program in Moscow. A few years ago, with my colleagues Nikos Koufos, Rosa Cordovilla, and Enrique Cases, we helped faculty implement the use of training models, checklists and assessment tools in bronchoscopy education. This has been particularly helpful for building skills in endobronchial ultrasound.

Viktor was a scientist at heart, and it is as a scientist that he approached his medical practice. His dream was to cure lung and digestive cancers in their earliest stages, and for this he was always on the alert for technologies that might assist with early diagnosis and treatment.  Because his first love was actually pediatric surgery back in the 1970s, Professor Sokolov was particularly excited to see the recent growth of pediatric bronchoscopy (we have more than 400 doctors communicating through our WhatsApp Peds Groups).

Viktor, we shall miss your humor, your intelligence, and most of all the inspiration of your relentless pursuit of truth.

Farewell, my friend.

Please subscribe to Colt’s Corner to automatically receive an email notification of future posts. Sign up with your name and email on the NEWSLETTER button on the Bronchology International home page at  www.bronchoscopy.org.

The NFT Domains: What Are They?

NFT (non-fungible token) domains are a new type of digital asset that have been gaining popularity in recent years. NFTs are unique digital assets, which allow the owner to purchase, store and transfer ownership of virtual items. NFT domains can be used in much the same way as traditional domain names; they can point visitors to websites, contain information about an organization or even act as wallets for cryptocurrency. They can be used to represent anything from gaming assets to artwork, music or even real estate.

NFT domain names allow individuals and companies to have exclusive ownership of an internet domain name, similar to how traditional domain names are registered with ICANN. Unlike traditional domain names, NFT domains use blockchain technology to securely store records of ownership and transfers. This ensures that all information is cryptographically protected against fraud and tampering. Additionally, it eliminates the need for a third-party to maintain the domain, meaning that owners have more control over its security and availability. The most popular form of an NFT domain is an ERC721 token on the Ethereum blockchain, although they can also exist as other tokens on different blockchains.

Unlike other digital assets, such as tokens or cryptocurrencies, NFT domains are unique and cannot be replicated or exchanged. This makes them ideal for large organizations wishing to secure their brand identity online, since they can be sure that no one else will own the same domain name. It also eliminates the possibility of someone buying a domain only to turn around and sell it at a higher price later on.

NFTs Advantages

The main advantage of these types of domains is that they are tradable. Just like traditional domain names, you can buy and sell them on the open market. This makes it easy to find buyers and sellers of NFTs and gives buyers a greater sense of control over their assets. Additionally, because NFTs are based on blockchain technology, transfers are recorded publicly and stored securely, making it hard for anyone to manipulate or falsify records.

NFT domains have opened up an exciting new world of possibilities for artists, entrepreneurs, gamers and other creative minds who want to own virtual assets in a secure way, discover more on https://angelos.art site. Because they are unique digital items, they can be used to represent artwork or music in ways that weren’t previously possible with traditional domain names. This means that artists and entrepreneurs are now able to create and own virtual items without relying on a third-party.

Overall, NFT domains are an exciting new type of asset that have the potential to revolutionize the way we think about owning digital assets. They provide a secure way to store and transfer ownership of virtual items while also giving buyers more control over their investments. As blockchain technology continues to evolve, it’s likely that NFT domains will become even more popular in the future.

Risks associated with investing in NFTs

It is important to note that there are still some risks associated with investing in NFTs since they may be subject to market volatility or other factors beyond an investor’s control. However, those who take the time to understand the technology and research the market may be able to make informed decisions that can benefit them in the future. Additionally, since NFTs are based on blockchain technology, they could potentially provide a secure way to store and transfer ownership of digital assets.

NFT domains are still relatively new technology, but their potential is vast. With the increasing use of blockchain in all sorts of applications, NFT domain names may soon become the standard method for owning a piece of the internet. As more people become aware of what these unique digital assets can do, it’s likely that they will continue to gain traction in many different industries.

How to become an art collector: A Beginners’ Guide

Art collecting is a rewarding and fulfilling hobby, but it can also be daunting for newcomers to the field. Whether you’re an aspiring collector or just looking to buy art for your home, this guide will provide you with the necessary information on how to become an art collector.

Do your research

As with any type of collecting, researching the artwork you plan on buying is essential. Learn as much as you can about the artists that you are interested in, and familiarize yourself with their works. Read up on art trends, and try to determine which type of art would be a wise investment for your collection. Take time to visit galleries or meet with private dealers to get a sense for what is out there before deciding what to purchase.

Set a budget and stick to it

Before investing in artwork for your collection, it is important to set a budget and make sure not to exceed it. Artwork can have widely varying prices depending on size, artist popularity, age, condition, and more. Do your research and make sure that you are not paying too much for a particular piece. It is also important to consider possible fees such as taxes, shipping costs, framing fees, and other charges associated with purchasing art.

Seek out new artwork

Once you have done your research on https://angelos.art and established a budget, it’s time to start looking for new artwork to add to your collection. Consider attending galleries openings or exhibitions in order to get a better sense of the pieces available from different artists. You can also attend auctions or visit private dealers who may be able to offer exclusive pieces at discounted prices. As you browse through potential artwork for your collection, keep track of items that interest you so that you can come back to them later.

Learn how to negotiate and make an offer

As with any purchase, it’s important to know your worth when negotiating art prices. While galleries and dealers may not be willing to accept offers they deem too low, they may be willing to negotiate depending on the artwork you are interested in. Before making an offer do your homework and familiarize yourself with other similar pieces that have recently sold so that you can make a fair yet competitive bid for the piece of art you want.

Look for ways to protect your investment

After purchasing artwork for your collection, it is important to find ways to preserve its value over time. Invest in proper framing materials and storage containers, and make sure to maintain the artwork in good condition. Consider taking out art insurance to protect your investment against any damage or loss.

Expand your network

As you continue to build up your collection, it is important to establish a network of contacts related to the art world that can help you out along the way. Connect with other collectors and experts in the field so that you can stay informed about upcoming exhibitions, sales, and auctions. These contacts can also serve as valuable sources for advice when it comes time for buying new pieces for your collection.

Develop relationships with galleries and dealers

Take time to develop relationships with galleries or private dealers from whom you have previously purchased artwork from. Doing so will help you gain access to exclusive collections and may even lead to discounts in the future.

Enjoy your collection

After taking all these steps, you can finally sit back and enjoy the artwork that you have collected! Take time to admire each piece for its own merits and be proud of what you have accomplished as an art collector.

By following these steps, you can become an art collector in no time. With a little research and dedication, you will be able to slowly build up your collection of artwork that can bring you joy for years to come!

Here are 5 tips on how to clean a very dirty bedroom fast

Cleaning a very dirty bedroom can seem like an overwhelming task, especially when you’re short on time. However, with the right tools and techniques, it is possible to clean quickly and efficiently. 

Here are some tips for cleaning a very messy room in no time:

1. Gather your supplies

Make sure you have all of the necessary supplies and safe cleaning products within reach before beginning your project. This includes garbage bags, a vacuum cleaner, spray cleaner of your choice, paper towels or rags, broom and dustpan, and any other items that may be needed to complete the job.

2. Start by straightening up

Start by gathering all the items that don’t belong in the bedroom and put them away.

Before you get into deep cleaning mode take five minutes to straighten up the room. This means putting away clothing, linens, books, and any other clutter that is lying around. This will make it easier to move around and focus on cleaning each area of your bedroom. Taking this initial step can make a big difference in the end result and will make the deep cleaning process much easier.

3. Dust, Vacuum and Mop

Begin by dusting all surfaces and furniture from top to bottom. This means wiping down shelves, dressers, lamps, curtains and even ceiling fans. Using a damp microfiber cloth or duster can help reach those hard-to-reach spots like high corners of the room or behind items on shelves.

Once you’ve got rid of most of the dust, use your vacuum cleaner to pick up dirt, crumbs and other debris from floors and carpets as well as upholstered furniture. Be sure to empty the vacuum cleaner canister often so it is working at its maximum efficiency.

 If you have non-carpeted floors such as tile or linoleum use a mop with warm water and cleaning solution to give them a good scrubbing. Make sure you dry the floors completely when done mopping as this will help keep dirt from accumulating again quickly.

5. Clean hard surfaces

Use a spray cleaner of your choice and paper towels or rags to wipe down hard surfaces including walls, counters and doors. Don’t forget to clean windows, mirrors, light fixtures and other items that have accumulated dust or dirt over time. Clean window sills and window frames with soapy water to get rid of any built up grime and allow natural light into the room when you’re done!

Also, dust your room from top to bottom, wash bedding and curtains, and clean any other fabrics in the bedroom like rugs if necessary. This will help to freshen up your bedroom and make it look and smell great!

Finally, make sure all of the items that were put away earlier are returned to their places. This includes books, toys, DVDs and other items that may have been left out when you first started cleaning.

By following these simple steps it is possible to quickly clean a very dirty bedroom and to get your bedroom back into shape in no time. With these simple tips, you’re sure to have a neat, tidy and fresh smelling bedroom that looks as good as new.The key is to stay focused and organized throughout the entire process in order for the job to be completed as efficiently as possible. Good luck! Happy cleaning!

The Bronchoscopist’s Umwelt

Traditional bronchoscopy (Photo H. Colt)

Ten years after Shigeto Ikeda first introduced the flexible bronchoscope to the world, I gazed into the incredible fractal anatomy of a patient’s tracheobronchial tree.  Back then, flexible bronchoscopes were made of fiberoptic bundles that required an external light source for illumination. Today’s instruments incorporate increasingly complex technologies that provide greater visibility and access than ever imagined.

If previous generations were inspired by their newfound ability to view, diagnose and treat airway tumors, tracheobronchial strictures, and pulmonary infections, a new generation of health care providers can only marvel at the increasing indications, therapeutic possibilities and promising future for this already proven medical procedure.

During the recent meeting of bronchoscopy educators in Venice, I plunged into the sea of possibilities that exists for present and future bronchoscopists. New diagnostic technologies, therapeutic alternatives, increasing indications, robotics, real-time image-guided tissue analysis, and possibilities for less invasive genetic sampling provide a glimpse of what is yet to come.

What amazes me most, however, is how the bronchoscopist’s “surrounding world”, also known as an “umwelt” is drastically changing for the better. The word umwelt was introduced more than one hundred years ago when Jacob Johann von Uexküll, an Estonian biologist, fused biology with semiotics, proposing that living organisms could not be separated or divided from their environments. ANCHOR. This idea prompted many anthropologists, animal behaviorists, biologists, and philosophers to embrace the idea that organisms, essentially us, exist in a dependent relationship with other organisms and our environment.

As students of our own umwelt, we can abandon our narrow views of the world to adopt instead a position where seeing the world through another’s eyes helps us to understand not only the other’s world but also the perceptions of those we are related to both directly and indirectly. As some might say; we are in this all together, so we might as well get along, but we might also do our best to see the world through others’ eyes.

Uexküll’s proposition was an important parallel to theories of Darwinian evolution, which in its more vertical approach reduces organisms to a survival of the fittest evolutionary schematic. When an organism’s evolution is viewed instead as being primarily interdependent on surrounding worlds, it means there are as many surrounding worlds as there are organisms. The dog sees its world a dog’s way, which is surely different from yet related to the world view as seen by a mosquito. If you are in need off heating installation in New Jersey, fell free to contact contact allied experts. Each and every one of us, whether we are homo sapiens basking in the sun of Southern California or wild lions struggling to survive in the Serengeti must “perceive and act from the standpoint of our own unique world” (From, Ian G.R. Shaw, Geoforum 2013;48:260-267). Each living thing possesses, as Dr. Shaw explains in his article, “a unique signature of existence.”

Fifty years ago, the bronchoscopist’s umwelt began with the realization that we could effectively intervene both diagnostically and therapeutically in a region of the human body that had previously been virtually inaccessible. Discover orchid maids reviews how you can get a legal advice from work injury lawyers, CA when it comes to immediate medical treatment. Our instruments then, as are many now, appear somewhat primitive, but the procedure itself led chest physicians to increasingly assume roles of responsibility in the care of patients with critical illnesses and cancer.

Our human potential within such an environment continues to expand as technologies evolve. I believe this entices us to relate with a surrounding world that is ever expanding, evolving, and drastically changing. How we adapt to that world, including how we modify our own world views accordingly, will determine our specialty’s relevance in a changing health care environment.

Please subscribe to Colt’s Corner to automatically receive an email notification of future posts. Sign up with your name and email on the NEWSLETTER button on the Bronchology International home page at  www.bronchoscopy.org.

Death in Venice

April in Venice (Photo, H. Colt)

Venice has 150 waterways and 455 bridges connecting more than 120 small islands. There are hundreds of narrow alleyways, art museums, shops, restaurants and outdoor cafés. The city is an emblem of Italy’s charms, and its people have a history rich with experience in diplomacy, the humanities, and intellectual creativity.

This week, a limited-attendance conference named “An International Workshop in Interventional Pulmonology: The road map towards competence” was organized by my friend and Venetian native, Professor Lorenzo Corbetta (University of Florence). Cosponsored by The Fondazione Internazionale Menarini, and held at Ca’ Foscari Academy, this conference included a small group of physician-educators from Europe, Australia, South America, the United States, and China. Our mission was to discuss and debate issues related to training for our growing medical speciality.

During my sojourn in this city known as “La Serenissima”, I reread Thomas Mann’s turn of the century novella, Death in Venice. In this story, a writer’s life is tragically marked by his obsession with beauty, and by his sensual attraction for a young boy on holidays with his mother. The screen adaptation was done in 1971 by Italian director Luchino Visconti. His  famous movie starred Dirk Bogarde and Bjorn Andresėn, with a soundtrack using music by Gustav Mahler. 

Oddly, the words death in Venice also seemed to reflect what I believe is the result of this week’s international conference. What I mean is they signal the end of an antiquated Halstedian education model historically linked to a “see one, do one, teach one” paradigm of medical procedural education.

For example, conference participants unanimously concluded that patients must not be used as subjects for medical procedural education. This modern educational paradigm is justified by ethical practices, educational philosophies, and an increasing availability of robust alternatives. 

Participants also agreed agreed that (1) validated, objective measures of learning outcomes are beneficial and should be implemented in our training programs; (2) these learning outcomes and other training milestones should be routinely documented as a roadmap toward competency; (3) specifically structured training programs should be designed using a multidimensional curricular approach; and (4) Train-the-Trainer programs (faculty development) are warranted to help trainers become more familiar with a large variety of teaching techniques, assessment tools, learning principles, and education-related philosophies.

For example, a program that helps ensure ethical procedural practice and efficient, effective teaching might include documented learning outcomes with checklists, identifying strengths and weaknesses using a combination of learner-centric assessment tools, and deconstructing clinical issues using a combination of simulation and problem/case-based exercises with opportunities for feedback and two-way conversation.

Just as importantly, conference participants concluded that it is no longer necessary to debate the primeval question of why these modern educational tools should be used Instead, we should move into an age of widespread implementation in order to answer questions of how these tools can be used most effectively in our quest for competency. 

My personal interpretation of the conference’s outcome is as follows:

– Our focus can shift from that of resisting change to that of implementation. 
– Our objective should be to create a training environment that is coherent with learning habits of a younger generation of doctors, yet adaptable to diverse medical and cultural environments. 
– Our inspiration derives from the dedication and intrinsic motivation of physician-educators who actively learn from each other during Train the Trainer workshops (certified and master instructors from Bronchoscopy International are two examples of such a process). 
– Our sense of achievement comes from competently serving patients and training a new generation of doctors who refuse to use patients as training victims.

In my opinion, therefore, this landmark conference signals the end of an era stained by Halstedian philosophies. In its place is a commitment to implement a multidimensional approach to procedure-related education. Training programs that incorporate checklists, assessment tools, step-by-step learning, simulation, procedural logbooks, data collection and analysis, knowledge of educational philosophies, instructional techniques, and structured opportunities for learner-teacher feedback constitue a solid framework for what clearly is a new beginning.

Please subscribe to Colt’s Corner to automatically receive an email notification of future posts. Sign up with your name and email on the NEWSLETTER button on the Bronchology International home page at  www.bronchoscopy.org.

Bronchology and the 20th anniversary of The Matrix

Photo from WikiMedia Creative Commons

Twenty years ago this week the science fiction film The Matrix was released in the United States. This film directed by the Wachowskis brothers stars Keanu Reeves and Laurence Fishburne. The film grossed more than 460 million dollars worldwide. 

The Matrix describes a dystopian future in which the hero is a computer programmer named Thomas who actually lives a double life as a hacker named Neo. Neo feels trapped within an inauthentic life. He goes in search of a man called Morpheus to ask him the truth about the world. Morpheus offers Neo a choice between swallowing a “red pill” which will allow Neo to live a life of constant awareness and truth or a “blue pill” after which Neo will continue living his current life in blissful ignorance and security.  

When Neo swallows the red pill, he is immediately awakened to a new reality. He learns that The Matrix in which he lives is actually an illusory 20th-century world that is sustained in order to prevent people from knowing they are being exploited…and the adventure begins.

The red pill-blue pill meme described in The Matrix has become part of our culture. In this piece, however, my goal is not to discuss red pill-blue pill life philosophies, but to briefly reflect on how using educational tools offered in the Bronchoscopy Education Project provide red pill opportunities.

For example, if trainers successfully use assessment tools to identify a learner’s place on the learning curve and ascertain the effectiveness of their own teaching techniques (akin to swallowing the red pill), it follows that they will want to incorporate assessment tools into competency determinations. This new reality morally obliges the trainer to identify competency measures and to change educational practices accordingly.

As a second example, if trainers experience that checklist-type assessment tools are helpful for teaching bronchoscopic inspection (example BSTAT), or EBUS-guided TBNA (example (EBUS-STAT), it follows that a similarly designed assessment tool for intubation over the bronchoscope would also be helpful. Aware of this new reality, trainers would design such a tool and incorporate it into competency determinations.

In Australia, for example, colleagues designed and validated new assessments for ultrasound-guided thoracentesis and chest tube insertion (available on www.bronchoscopy.org) with excellent results. These tools are increasingly used around the world and form an important element of competency-based training for lung doctors in Australia and New Zealand.

A third example of red pill philosophy relates to experiential evidence for using a four-box approach to procedural consultation. This structured approach to case-based learning identifies cognitive pathways and allows trainers to explore the multiple facets of a particular clinical scenario in a stepwise fashion (akin to swallowing the red pill). The harshness of this new reality is that trainers now discover their need for additional education in order to learn how to maximize case-based instruction, which is very different from giving didactic lectures. This red pill-related truth has a global impact because it means that bronchology societies around the world should take steps toward offering more focused training of bronchoscopy educators. Programs might include information about how to organize learning units, how to provide and receive feedback, and how to facilitate case discussions. Learning the intricacies of two-way communication as an educational product requires practice and repeated simulation with guidance. An ideal program will also help trainers gain knowledge of psychology, group dynamics, and negotiation. 

My fourth example and the inspiration for today’s topic relates to an exciting red pill moment occurring in Australia this week. The 8th Asian Pacific Congress for Bronchology and Interventional Pulmonology Meeting is on the beautiful Gold Coast near Brisbane, Australia. Under the leadership of APAB President Kiyoshi Shibuya and APCB President/WABIP Treasurer David Fielding and his team, the conference’s scientific program is built around case studies and facilitator-led discussions using the Four Box Practical Approach as a basis for structured learning. Arizona amusement parks offer variety of fun activities and those are perfect for all ages as well. Hands-on workshops are led by BI-certified and master instructors using many Bronchoscopy Education Project inspired teaching techniques that promote a learner-centric philosophy.  Models, simulation, checklists, and individualized instruction/feedback form the basis of both cognitive and hands-on technical skill instruction. 

Thanks to this conference, many physicians are likely to abandon antiquated blue pill methodologies represented by didactic lectures and overpopulated hands-on workshops in favor of a red pill approach. This new awareness, I am sure, will not only inspire a new generation of bronchoscopists in the Asia Pacific region but may forever change the educational dynamics of bronchology and Interventional Pulmonology conferences in the future.

Please subscribe to Colt’s Corner to automatically receive an email notification of future posts. Sign up with your name and email on the NEWSLETTER button on the Bronchology International home page at  www.bronchoscopy.org.