Table 1 UK surveys involving Higher speciality trainee experience of CTI

Connick 2009 East Anglia [9]

181/186 hospital practitioners from 2 centres

All grades responded including 55 registrars

To assess self-reported confidence in performing practical procedures.

58% of all respondents felt confident in CTI and 70% felt confident in pleural aspiration.

61% of Registrars/Consultants felt all practitioners should be competent in pleural aspiration and 56% in CTI.

Corcoran 2015 Oxford [11]

117 general physicians responded including 48 medical registrars and 38 core medical trainees

To ascertain doctors’ perception of the minimum numbers of procedures to attain/maintain CTI competence, experience to date of CTIs and assess knowledge

51% of respondents managed scenarios correctly.

89% registrars performed enough to achieve competence, 25% performed enough in last year to maintain competence (5–10 to achieve and 5–10 per year to maintain).

47.7% of trainees (core medical trainees and registrars) never had access to simulation training in CTI.

57% of trainees never had any TUS training and didn’t expect any in the future.

Corcoran, 2016 Oxford [10]

66 participants – 21 Core medical trainees and 45 registrars across 4 hospitals.

To identify whether medical trainees can identify a safe site in which to perform a CTI for a pneumothorax in the safety of triangle

45 registrars performed CTI previously and 20/21 core medical trainees had performed a CTI previously.

60.6% of all trainees could identify a site within the triangle of safety (there was no statistical significance between HST and core medical trainees p = 1.0)

Griffiths, 2005 Sheffield [14]

55 junior doctors (from foundation year 1 – registrars) surveyed in a single teaching hospital.

Only 2 doctors were registrars

To assess whether junior doctors could safely identify an area inside the safe triangle to site a chest drain

45% of junior doctors stated they would site a chest drain outside the safe triangle.

28/55 junior doctors had performed a chest drain.

3/11 who had performed a chest drain under supervision intended to site a chest drain outside the safe triangle and 3/17 who had performed a chest drain unsupervised would site this outside the safe triangle

Lagan 2015 Wirral [12]

156/269 doctors returned survey.

73 registrars and 83 core trainees

To assess trainee procedural confidence.

To explore procedural training and exposure to procedures

To demonstrate correlation between confidence and exposure.

70% wanted to perform more procedures, 3.8% wanted fewer procedures and 26% wanted the same number.

80% disagreed that “practical procedures should be reserved for specialists with an interest in them”. 98.7% agreed they should be procedurally competent in case of emergencies.

21% registrars not independent in chest drains and 61% core medical trainees not independent. 81% not independent in TUS for pleural procedures and 40% had no training in chest ultrasound for pleural procedures.

Procedural exposure statistically associated with confidence (p < 0.003) and significant correlation between chest ultrasound and confidence for pleural procedures (P < 0.017)

Miller, 2020 Torbay (Poster presentation at national conference) [13]

137 responses from 8 hospitals including 39 general medical registrars

Aims were to identify pleural practices in the region including the number of procedures performed, self-rated confidence of operators undertaking them out of hours and the availability of standard operating procedures (SOPs), safety checklists and procedure rooms

90.4% of respondents said out of hours procedures were the responsibility of the general medical registrars.

39 General medical registrars had a mean confidence of 2.4/5 (95% CI of 2.09, 2.78) in performing emergency CTI.

Respiratory registrars had an average confidence of 3.9/5 (95% CI 3.26,4.55).

70.7% of general medical registrars desired further training.

53.3% of respondents knew of a pleural safety checklist and only 20.7% were using this regularly.

53% did not know where to find a standard operating procedure for pleural procedures.

18% of respiratory trainees had regular access to a procedural room.