Strategies for training in diagnostic upper endoscopy: a prospective, randomized trial - 15/01/12
Reprint requests: Juergen Maiss, MD, Gastroenterology Clinic, Dr. Kerzel/PD Dr. Maiss, Mozartstr. 1, 91301 Forchheim, GermanyRésumé |
Background |
Training simulators have been used for decades with success; however, a standardized educational strategy for diagnostic EGD is still lacking.
Objective |
Development of a training strategy for diagnostic upper endoscopy.
Study design |
Prospective, randomized trial.
Settings |
A total of 28 medical and surgical residents without endoscopic experience were enrolled. Basic skills evaluations were performed following a structured program involving theoretical lectures and a hands-on course in diagnostic EGD. Subsequently, stratified randomization to clinical plus simulator training (group 1, n = 10), clinical training only (group 2, n = 9), or simulator training only (group 3, n = 9) was performed. Ten sessions of simulator training were conducted for groups 1 and 3 during the 4-month program. Group 2 underwent standard training in endoscopy without supplemental simulator training. The final evaluation was performed on the simulator and by observation of 3 clinical cases. Skills and procedural times were recorded by blinded and unblinded evaluators.
Main Outcome Measurements |
Time to reach the duodenum, pylorus, or esophagus.
Results |
All trainees demonstrated a significant reduction in procedure time during a simple manual skills test (P < .05) and significantly better skills scores (P = .006, P = .042 and P = .017) in the simulator independent of the training strategy. Group 1 showed shorter times to intubate the esophagus (61 ± 26 seconds vs 85 ± 30 seconds and 95 ± 36 seconds) and the pylorus (183 ± 65 seconds vs 207 ± 61 seconds and 247 ± 66 seconds) during the clinical evaluation. Blinded assessment of EGD skills showed significantly better results for group 1 compared with group 3. Blinded and unblinded evaluations were not statistically different.
Limitations |
Small sample size.
Conclusions |
Structured simulator training supplementing clinical training in upper endoscopy appears to be superior to clinical training alone. Simulator training alone does not seem to be sufficient to improve endoscopic skills.
Le texte complet de cet article est disponible en PDF.Abbreviation : EASIE
Plan
| DISCLOSURE: The authors disclosed no financial relationships relevant to this publication. This study was supported by the Association for Quality-Oriented Training in Endoscopy e.V. Erlangen, a nonprofit organization for research and support of the value of training and assessment in endoscopy. Specimens and compactEASIEs were donated by this organization. |
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| If you would like to chat with an author of this article, you may contact Dr Maiss at [email protected]. |
Vol 75 - N° 2
P. 254-260 - février 2012 Retour au numéro
Article précédent
- Diagnostic accuracy of EUS in differentiating mucosal versus submucosal invasion of superficial esophageal cancers: a systematic review and meta-analysis
- Nirav Thosani, Harvinder Singh, Asha Kapadia, Nobuo Ochi, Jeffrey H. Lee, Jaffer Ajani, Stephen G. Swisher, Wayne L. Hofstetter, Sushovan Guha, Manoop S. Bhutani
- Ain't nothing like the real thing? Simulators in endoscopy training
- Harry R. Aslanian
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