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Tytuł:
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Effect of individualized feedback on learning curves in EGD and colonoscopy: a cluster randomized controlled trial.
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Autorzy:
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Han S; Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA.
Obuch JC; Division of Gastroenterology, Geisenger Medical Center, Danville, Pennsylvania, USA.
Keswani RN; Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Chicago, Illinois, USA.
Hall M; Children's Hospital Association, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Patel SG; Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA.
Menard-Katcher P; Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA.
Simon V; Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA.
Ezekwe E; Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA.
Aagaard E; Washington University School of Medicine in St. Louis, St Louis, Missouri, USA.
Ahmad A; Division of Gastroenterology and Hepatology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Alghamdi S; Division of Gastroenterology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
Austin K; Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine, Madison, Wisconsin, USA.
Brimhall B; Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA.
Broy C; Division of Gastroenterology, Advocate Lutheran General Hospital, Park Ridge, Illinois, USA.
Carlin L; Colorado Clinical and Translational Sciences Institute, University of Colorado Anschutz Medical Center, Aurora, Colorado.
Cooley M; Division of Gastroenterology, Ascension Providence Hospital, Southfield, Michigan, USA.
Di Palma JA; Division of Gastroenterology, University of South Alabama, Mobile, Alabama, USA.
Duloy AM; Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA.
Early DS; Division of Gastroenterology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
Ellert S; Colorado Clinical and Translational Sciences Institute, University of Colorado Anschutz Medical Center, Aurora, Colorado.
Gaumnitz EA; Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine, Madison, Wisconsin, USA.
Goyal J; Division of Gastroenterology, University of Miami, Miami, Florida, USA.
Kathpalia P; Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, California, USA.
Day L; Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, California, USA.
El-Nachef N; Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, California, USA.
Kerman D; Division of Gastroenterology, University of Miami, Miami, Florida, USA.
Lee RH; Division of Gastroenterology, University of California, Irvine, Irvine, California, USA.
Lunsford T; Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
Mittal M; Division of Gastroenterology, University of California, Irvine, Irvine, California, USA.
Morigeau K; Division of Gastroenterology, University of Texas Health San Antonio, San Antonio, Texas, USA.
Pietrak S; Division of Gastroenterology and Hepatology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Piper M; Division of Gastroenterology, Ascension Providence Hospital, Southfield, Michigan, USA.
Shah AS; Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.
Shapiro AB; Division of Gastroenterology, Advocate Lutheran General Hospital, Park Ridge, Illinois, USA.
Shergill A; Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, California, USA.
Sonnier W; Division of Gastroenterology, University of South Alabama, Mobile, Alabama, USA.
Sorrell C; Division of Gastroenterology, University of Texas Health San Antonio, San Antonio, Texas, USA.
Vignesh S; Division of Gastroenterology and Hepatology, SUNY Downstate Medical Center, Brooklyn, New York, USA.
Wani S; Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA.
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Źródło:
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Gastrointestinal endoscopy [Gastrointest Endosc] 2020 Apr; Vol. 91 (4), pp. 882-893.e4. Date of Electronic Publication: 2019 Nov 09.
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Typ publikacji:
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Journal Article; Multicenter Study; Randomized Controlled Trial
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Język:
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English
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Imprint Name(s):
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Publication: St Louis, Mo : Mosby Yearbook
Original Publication: Denver.
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MeSH Terms:
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Learning Curve*
Clinical Competence ; Colonoscopy ; Feedback ; Gastroenterology/education ; Humans
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Molecular Sequence:
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ClinicalTrials.gov NCT02891304
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Entry Date(s):
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Date Created: 20191113 Date Completed: 20210401 Latest Revision: 20210401
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Update Code:
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20240105
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DOI:
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10.1016/j.gie.2019.10.032
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PMID:
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31715173
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Background and Aims: Gastroenterology fellowships need to ensure that trainees achieve competence in upper endoscopy (EGD) and colonoscopy. Because the impact of structured feedback remains unknown in endoscopy training, this study compared the effect of structured feedback with standard feedback on trainee learning curves for EGD and colonoscopy.
Methods: In this multicenter, cluster, randomized controlled trial, trainees received either individualized quarterly learning curves or feedback standard to their fellowship. Assessment was performed in all trainees using the Assessment of Competency in Endoscopy tool on 5 consecutive procedures after every 25 EGDs and colonoscopies. Individual learning curves were created using cumulative sum (CUSUM) analysis. The primary outcome was the mean CUSUM score in overall technical and overall cognitive skills.
Results: In all, 13 programs including 132 trainees participated. The intervention arm (6 programs, 51 trainees) contributed 558 EGD and 600 colonoscopy assessments. The control arm (7 programs, 81 trainees) provided 305 EGD and 468 colonoscopy assessments. For EGD, the intervention arm (-.7 [standard deviation {SD}, 1.3]) had a superior mean CUSUM score in overall cognitive skills compared with the control arm (1.6 [SD, .8], P = .03) but not in overall technical skills (intervention, -.26 [SD, 1.4]; control, 1.76 [SD, .7]; P = .06). For colonoscopy, no differences were found between the 2 arms in overall cognitive skills (intervention, -.7 [SD, 1.3]; control, .7 [SD, 1.3]; P = .95) or overall technical skills (intervention, .1 [SD, 1.5]; control, -.1 [SD, 1.5]; P = .77).
Conclusions: Quarterly feedback in the form of individualized learning curves did not affect learning curves for EGD and colonoscopy in a clinically meaningful manner. (Clinical trial registration number: NCT02891304.).
(Copyright © 2020 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
