Background and Goal of Study: Anesthesiologists and pulmonologists need to train bronchoscopy before performing this procedure. We developed a cost-effective bronchial tree simulator based on human thorax CT-scans, using rapid prototyping (3D-Print) technology. This randomized, single-blinded study evaluated how realistic our 3D-printed simulator would mimic human anatomy compared to two commercially available bronchial tree simulators.
Materials and Methods: 30 experienced anesthetists and pulmonologists (Bern University Hospital) used a fiberoptic bronchoscope and rated on a visual analog scale (VAS) (0mm = completely unrealistic anatomy and 100mm = indistinguishable from real patient) the following for each of the three simulators:
1) Localization of the right upper lobe
2) Placement of a bronchial blocker in the left main bronchus
3) Aspiration of fluid from the right lower lobe
4) Overall realism 
The commercial simulators were: Laerdal Airway Management Trainer with Bronchial Tree (Laerdal Stavanger, Norway) and the AirSim Advance Bronchi (TruCorp® Ltd, Belfast, Northern Ireland).
Results and Discussion: The 3D-printed simulator was rated most realistic for the localization of the right upper lobe. There was no difference between the simulators in placement of a bronchial blocker into the left main Bronchus or for aspiration of fluid (Table). Finally the overall realism rating of the 3D-printed simulator was superior. 
0.021
[VAS scores (median, interquartile range); Friedman]

The 3D-printed simulator performs equally well or even better compared to the two other simulators. Given the costs of approximately 1.000€ for Laerdal, 3.500€ for TruCorp versus only 90€ for the 3D-printed simulator, superiority of the 3D-printed simulator was reached with less than 10% of the costs.
Conclusion: The 3D-printed bronchial tree is superior to the substantially more expensive commercially available simulators. This means that a CT-based printed simulator is an inexpensive alternative for training basic bronchoscopy skills.

How realistic are low cost, low fidelity bronchoscopy simulators?