Introduction
Flexible bronchoscopy (FB) is a core competency for respiratory trainees. Access and experience can vary depending on level and location of training.
Aims
Simulation based training in FB has been shown to be a more efficient training method than the classic apprenticeship format (Naur, TMH et al. Respiration. 2017; 93(5):355-362). The course intended to improve candidates? knowledge and confidence in domains related to FB including endobronchial anatomy, sedation, indications, complications, and sampling techniques.
Methods
The one day course included lectures, live FB observation and time dedicated to handling a FB simulator (ORSIM©). Pre- and post-test confidence questionnaires utilised the same 5-point Likert scales and yes-no questions. This enabled candidates to recognise specific skills gained as well as their newfound knowledge and confidence within the domains.
Results
Candidates (n=11) were medical or respiratory trainees, the majority in year 3 (junior registrar). Prior exposure was limited, 82% had performed or observed fewer than 15 FB; 3 had never done either. 
27% felt able to consent, sedate and intubate before the course. This increased to 100%, 82% and 91% in each skill respectively afterwards.
Likert scales were converted to numerical values (1-5) for analysis. All candidates were more (or equally) confident in all assessed domains. Knowledge of sampling techniques and managing complications had the greatest increase (?2/5).

Conclusion
Live demonstration and simulation were utilised to formulate a focussed training experience. Skills acquired are directly transferrable to clinical practice enabling accelerated future development of proficiencies related to FB.