This chapter examines the evolution and current status of competency-based medical education (CBME) in interventional pulmonology, focusing on procedural skills assessment and training. Traditionally, interventional pulmonology training has used an apprenticeship model with case logs and director attestation, leading to inconsistent outcomes due to a lack of standardized curricula. CBME, established to address these issues, relies on outcome-based assessments to ensure trainees achieve necessary competencies. The chapter reviews various assessment tools, including global rating scales, checklists, and simulation-based methods, and their effectiveness in skill acquisition and clinical evaluation. It also covers specific procedures such as EBUS-TBNA, electromagnetic navigation bronchoscopy, and rigid bronchoscopy, discussing their assessment tools and learning curves. The chapter emphasizes the need for standardized assessment tools and suggests using entrustable professional activities (EPAs) to improve competency evaluation. Future directions include integrating real-time artificial intelligence feedback, addressing high-risk low-volume procedures, and enhancing workplace-based assessments to improve interventional pulmonology training and patient care quality. This chapter reviews the transition from traditional apprenticeship models to CBME in interventional pulmonology, highlighting advancements in procedural skills assessment, the effectiveness of various assessment tools, and future directions for improving training and patient care.
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