Non‐technical skills curriculum incorporating simulation‐based training improves performance in colonoscopy among novice endoscopists: Randomized controlled trial

Walsh, Catharine M.; Scaffidi, Michael A.; Khan, Rishad; Arora, Anuj; Gimpaya, Nikko; Ping, Lin; Satchwell, Joshua B.; Al‐Mazroui, Ahmed; Zarghom, Omid; Sharma, Suraj; Kamani, Alya; Genis, Shai; Kalaichandran, Ruben; Grover, Samir C.

doi:10.1111/den.13623

Cited by 34 publications

(33 citation statements)

References 36 publications

(40 reference statements)

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“…First, emphasis should shift toward maximizing gains from evidence-based, hands-off training interventions. For beginners, simulation-based training can be used to develop technical 25,26 and nontechnical skills 27 and to accelerate time to achievement of competence. 28 Although simulation training requires performance feedback to be optimally effective, 29 self-assessment with benchmark videos and computerized feedback are viable alternatives.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on endoscopy trainees: an international survey

Pawlak

Král

Khan

et al. 2020

Gastrointestinal Endoscopy

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139

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Background and Aims: Although coronavirus disease 2019 (COVID-19) has affected endoscopy services globally, the impact on trainees has not been evaluated. We aimed to assess the impact of COVID-19 on procedural volumes and on the emotional well-being of endoscopy trainees worldwide. Methods: An international survey was disseminated over a 3-week period in April 2020. The primary outcome was the percentage reduction in monthly procedure volume before and during COVID-19. Secondary outcomes included potential variation of COVID-19 impact between different continents and rates and predictors of anxiety and burnout among trainees. Results: Across 770 trainees from 63 countries, 93.8% reported a reduction in endoscopy case volume. The median percentage reduction in total procedures was 99% (interquartile range, 85%-100%), which varied internationally (P < .001) and was greatest for colonoscopy procedures. Restrictions in case volume and trainee activity were common barriers. A total of 71.9% were concerned that the COVID-19 pandemic could prolonged training. Anxiety was reported in 52.4% of respondents and burnout in 18.8%. Anxiety was independently associated with female gender (odds ratio [OR], 2.15; P < .001), adequacy of personal protective equipment (OR, 1.75; P Z .005), lack of institutional support for emotional health (OR, 1.67; P Z .008), and concerns regarding prolongation of training (OR, 1.60; P Z .013). Modifying existing national guidelines to support adequate endoscopy training during the pandemic was supported by 68.9%. Conclusions: The COVID-19 pandemic has led to restrictions in endoscopic volumes and endoscopy training, with high rates of anxiety and burnout among endoscopy trainees worldwide. Targeted measures by training programs to address these key issues are warranted to improve trainee well-being and support trainee education.

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Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on endoscopy trainees: an international survey

Pawlak

Král

Khan

et al. 2020

Gastrointestinal Endoscopy

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139

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“…The course covers a colonoscopy curriculum ranging from sedation, lesion recognition, optimal positions and troubleshooting techniques. During hands-on sessions, trainees are subjected to rigorous performance review of technical aspects, e.g ., scope handling, loop avoidance and resolution, to non-technical skills[ 21 ], e.g ., situational awareness, which can impact on progress and patient comfort. Tailored high-performance feedback, based on the DOPS formative assessment tool[ 22 ], is provided for each trainee and backed by future goal setting to encourage practice changes within their usual training environment.…”

Section: Discussionmentioning

confidence: 99%

Impact of a national basic skills in colonoscopy course on trainee performance: An interrupted time series analysis

Siau

Hodson²,

Anderson

et al. 2020

WJG

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BACKGROUND The Joint Advisory Group on Gastrointestinal Endoscopy basic skills in colonoscopy (BSC) course was introduced in 2009 to improve colonoscopy training within the United Kingdom, but its impact on trainee performance is unknown. AIM To assess whether attendance of the BSC could improve colonoscopy performance. METHODS Trainees awarded colonoscopy certification between 2011-2016 were stratified into 3 groups according to pre-course procedure count (< 70, 70-140 and > 140). Study outcomes, comprising the unassisted caecal intubation rate (CIR) and the performance indicator of colonic intubation (PICI), were studied over the 50 procedures pre and post- course. Interrupted time series analyses were performed to detect step-change changes attributable to the course. RESULTS A total of 369 trainees with pre-course procedure counts of < 70 ( n = 118), 70-140 ( n = 121) and > 140 ( n = 130) were included. Over the 50 pre-course procedures, significant linear improvements in CIR were found, with average increases of 4.2, 3.6 and 1.7 percentage points (pp) per 10 procedures performed in the < 70, 70-140 and > 140 groups respectively (all P < 0.001). The < 70 procedures group saw a significant step-change improvement in CIR, increasing from 46% in the last pre-course procedure, to 51% in the first procedure post-course ( P = 0.005). The CIR step-change was not significant in the 70-140 (68% to 71%; P = 0.239) or > 140 (86% to 87%; P = 0.354) groups. For PICI, significant step-change improvements were seen in all three groups, with average increases of 5.6 pp ( P < 0.001), 5.4 pp ( P = 0.003) and 3.9 pp ( P = 0.014) respectively. CONCLUSION Attendance of the BSC was associated with a significant step-change improvement in PICI, regardless of prior procedural experience. However, CIR data suggest that the optimal timing of course attendance appears to be at earlier stages of training (< 70 procedures).

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“…Para esta pandemia es importante mejorar ambos tipos de habilidades. Dentro de las habilidades no técnicas encontramos el liderazgo, el trabajo en equipo, la comunicación efectiva, la conciencia situacional y la toma de decisiones (18) , los cuales son factores importantes en la atención médica, su optimización puede reducir el error del sistema y fallas en la coordinación de los equipos de atención (19)(20)(21)(22) . Una reciente revisión sistemática de incidentes críticos en unidades de cuidados intensivos encontró que las fallas en dominios no técnicos contribuyeron a una gran proporción de errores médicos (20) , por lo tanto, las mejoras en estas habilidades pueden traer beneficios al sistema de atención.…”

Section: Realimentaciónunclassified