Table 2 Single best answer selections for each of the four clinical vignettes
Clinical Vignette | Single Best Answer (SBA) | Pleural consultant (participants n/N (%)) | Respiratory HST (participants n/N (%)) | General HST (participants n/N (%)) | ICM/anaesthetic HST (participants n/N (%)) |
|---|---|---|---|---|---|
A 32 year old male with no past medical history presents with left sided chest pain. He is not breathless. A chest X-ray shows a left pneumothorax measuring 3 cm at the apex and 1.5 cm at the hilum. Oxygen saturations 95% on room air. Your treatment plan is to: | A Discharge home, outpatient follow upa | 6/7 (85.7) | 11/12 (91.7) | 45/63 (71.4) | 6/12 (50.0) |
B Pleural aspiration without the use of ultrasound | 1/7 (14.3) | 0 | 4/63 (6.3) | 1/12 (8.3) | |
C Pleural aspiration with the use of ultrasound | 0 | 1/12 (8.3) | 12/63 (19.0) | 3/12 (25.0) | |
D Chest drain without the use of ultrasound | 0 | 0 | 1/63 (1.6) | 1/12 (8.3) | |
E Chest drain guided with the use of ultrasound | 0 | 0 | 1/63 (1.6) | 1/12 (8.3) | |
A 57-year-old male with COPD presents with breathless. A CXR shows a right pneumothorax measuring 3 cm at the hilum. Your treatment plan is: | A Discharge home, outpatient follow up | 0 | 0 | 0 | 0 |
B Pleural aspiration without the use of ultrasound | 0 | 1/12 (8.3) | 0 | 0 | |
C Pleural aspiration with the use of ultrasound | 0 | 0 | 10/63 (15.9) | 0 | |
D Chest drain without the use of ultrasounda | 6/7 (85.7) | 6/12 (50.0) | 16/63 (25.4) | 4/12 (33.3) | |
E Chest drain guided with the use of ultrasound | 1/7 (14.3) | 5/12 (42.0) | 37/63 (58.7) | 8/12 (66.7) | |
A 50-year-old female with known lung cancer presents with shortness of breath. A Chest X-ray reveals a large right sided pleural effusion not present on a CXR performed four months earlier. Your treatment plan is: | A Discharge home, outpatient follow up | 0 | 0 | 2/63 (3.2) | 0 |
B Pleural aspiration without the use of ultrasound | 0 | 0 | 1/63 (1.6) | 0 | |
C Pleural aspiration with the use of ultrasounda | 7/7 (100) | 11/12 (91.7) | 42/63 (66.7) | 8/12 (66.7) | |
D Chest drain without the use of ultrasound | 0 | 0 | 0 | 0 | |
E Chest drain guided with the use of ultrasound | 0 | 1/12 (8.3) | 18/63 (29) | 4/12 (33.3) | |
A 65-year female with known lung cancer presents with dyspnoea on exertion. She previously had 1.5 L of fluid removed from the right pleural space 2 weeks ago, cytology demonstrated adenocarcinoma cells present. Exercise tolerance < 10 yards. Oxygen saturations 90% on air. CXR shows a large right sided pleural effusion. Your treatment plan is: | A Discharge home, outpatient follow up | 0 | 0 | 1/63 (1.6) | 2/12 (16.7) |
B Pleural aspiration without the use of ultrasound | 0 | 0 | 0 | 0 | |
C Pleural aspiration with the use of ultrasound | 1/7 (14.3) | 4/12 (33.3) | 17/63 (27.0) | 2/12 (16.7) | |
D Chest drain without the use of ultrasound | 0 | 0 | 0 | 0 | |
E Chest drain guided with the use of ultrasounda | 6/7 (85.7) | 8/12 (66.7) | 45/63 (71.4) | 8/12 (66.7) |