EUS core curriculum

DiMaio, Christopher J.; Mishra, Girish; McHenry, Lee; Adler, Douglas G.; Coyle, Walter; Dua, Kulwinder S.; DeGregorio, Barry; Enestvedt, Brintha K.; Lee, Linda; Mullady, Daniel; Pais, Shireen; Rajan, Elizabeth; Sedlack, Robert E.; Tierney, William M.; Faulx, Ashley L.

doi:10.1016/j.gie.2012.04.437

Cited by 48 publications

(19 citation statements)

References 11 publications

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“…With this comes a critical need for a better understanding of the learning curve to achieve competency in EUS, highlighted by the increasing emphasis on competency-based medical education 2 3. Unfortunately, due to the current lack of clarity for competency-based assessment in EUS, training programs are still dependent on procedural thresholds to help ensure their trainees achieve competency.…”

Section: Introductionmentioning

confidence: 99%

When trainees reach competency in performing endoscopic ultrasound: a systematic review

Shahidi

Lam

et al. 2017

Endosc Int Open

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Background/Study aim The American Society for Gastrointestinal Endoscopy (ASGE) recommends that trainees complete 150 endoscopic ultrasound (EUS) procedures before assessing competency. However, this recommendation is largely based on limited evidence and expert opinion. With new evidence suggesting that this historical threshold is underestimating training requirements, we evaluated the learning curve for achieving competency in EUS. Patients/Materials and methods Two investigators independently searched MEDLINE for full-text citations assessing the learning curve for achieving competency in EUS in the period 1946 to 25 March 2016. A learning curve was defined as either a tabulated or graphic representation of competency as a function of increasing EUS experience. Results Eight studies assessing 28 trainees and 7051 EUS procedures were included. When stratifying studies based on procedural indication: three studies assessed competency in evaluating mucosal lesions, three studies assessed competency in EUS fine-needle aspiration (EUS-FNA), and two studies assessed comprehensive competency. Among studies assessing mucosal lesion T-staging accuracy, competency was achieved by 65 to 231 procedures. Among studies assessing EUS-FNA, competency was achieved by 30 to 40 procedures. Among the two studies assessing comprehensive competency in EUS, competency was not achieved in either study across all trainees. Only four of 17 trainees reached competency by 225 to 295 EUS procedures. Conclusion As EUS competency assessment has evolved to more closely reflect independent clinical practice, the number of procedures required to achieve competency has risen well above ASGE recommendations. Advanced endoscopy training programs and specialty societies need to re-assess the structure of EUS training.

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Section: Introductionmentioning

confidence: 99%

When trainees reach competency in performing endoscopic ultrasound: a systematic review

Shahidi

Lam

et al. 2017

Endosc Int Open

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“…Since endoscopic ultrasound (EUS) was first introduced in the early 1980s, it has evolved into a valuable diagnostic and therapeutic tool for the management of intra‐ and extraluminal gastrointestinal pathology. The addition of fine‐needle aspiration (FNA) allows physicians to safely and effectively access areas in the gastrointestinal (GI) tract that were only previously accessible by percutaneous or surgical means . Common current indications for EUS include local staging of malignancies (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…The addition of fine-needle aspiration (FNA) allows physicians to safely and effectively access areas in the gastrointestinal (GI) tract that were only previously accessible by percutaneous or surgical means. 1 Common current indications for EUS include local staging of malignancies (e.g. pancreas, esophageal, gastric, and rectal), evaluation of solid and cystic pancreatic lesions, [2][3][4] gastrointestinal submucosal masses, 5 and intra-abdominal and mediastinal lymphadenopathy.…”

Section: Introductionmentioning

confidence: 99%

Multicenter evaluation of the utilization of endoscopic ultrasound

D’Souza

Holub

Pavic

et al. 2016

Digestive Endoscopy

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This is the largest survey of EUS practice in the USA. Evaluation of the pancreas accounts for approximately 40% of the indications for EUS. Use of EUS increased over the study period, and the proportion carried out with deep sedation or general anesthesia also increased. These data may have implications regarding the number of endosonographers who should be trained, as well as cost issues pertaining to increasing use of anesthesia providers and same-day ERCP.

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“…Endoscopists undertaking interventional EUS procedures should be highly skilled in ERCP techniques such as wire manipulation and fluoroscopic interpretation in addition to being proficient in EUS-FNA. Although prior ASGE documents have suggested minimum procedure thresholds for assessing competency in ERCP and EUS, 108,109 there are no defined competency criteria for interventional EUS procedures. Further, within interventional EUS procedures there is a spectrum of difficulty and risk, and individual endoscopists may choose to pursue proficiency at only selected procedures.…”

Section: Need For Specialized Trainingmentioning

confidence: 99%