A Prospective Multicenter Study Evaluating Learning Curves and Competence in Endoscopic Ultrasound and Endoscopic Retrograde Cholangiopancreatography Among Advanced Endoscopy Trainees: The Rapid Assessment of Trainee Endoscopy Skills Study.

Autor:	Wani S; University of Colorado Anschutz Medical Campus, Aurora, Colorado. Electronic address: sachinwani10@yahoo.com., Keswani R; Northwestern University, Chicago, Illinois., Hall M; University of Colorado Anschutz Medical Campus, Aurora, Colorado., Han S; University of Colorado Anschutz Medical Campus, Aurora, Colorado., Ali MA; University Hospitals Cleveland Medical Center, Cleveland, Ohio., Brauer B; University of Colorado Anschutz Medical Campus, Aurora, Colorado., Carlin L; Colorado Clinical and Translational Sciences Institute, Aurora, Colorado., Chak A; University Hospitals Cleveland Medical Center, Cleveland, Ohio., Collins D; Carolinas Medical Center, Charlotte, North Carolina., Cote GA; Medical University of South Carolina, Charleston, South Carolina., Diehl DL; Geisinger Medical Center, Danville, Pennsylvania., DiMaio CJ; Icahn School of Medicine at Mount Sinai, New York, New York., Dries A; Carolinas Medical Center, Charlotte, North Carolina., El-Hajj I; Indiana University, Indianapolis, Indiana., Ellert S; Colorado Clinical and Translational Sciences Institute, Aurora, Colorado., Fairley K; Geisinger Medical Center, Danville, Pennsylvania., Faulx A; University Hospitals Cleveland Medical Center, Cleveland, Ohio., Fujii-Lau L; Washington University School of Medicine, St Louis, Missouri., Gaddam S; Washington University School of Medicine, St Louis, Missouri., Gan SI; Virginia Mason Medical Center, Seattle, Washington., Gaspar JP; University of Virginia Health System, Charlottesville, Virginia., Gautamy C; Moffitt Cancer Center, Tampa, Florida., Gordon S; Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire., Harris C; Moffitt Cancer Center, Tampa, Florida., Hyder S; Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire., Jones R; Carolinas Medical Center, Charlotte, North Carolina., Kim S; University of California, Los Angeles, Los Angeles, California., Komanduri S; Northwestern University, Chicago, Illinois., Law R; Northwestern University, Chicago, Illinois., Lee L; Brigham and Women's Hospital, Boston, Massachusetts., Mounzer R; University of Colorado Anschutz Medical Campus, Aurora, Colorado., Mullady D; Washington University School of Medicine, St Louis, Missouri., Muthusamy VR; University of California, Los Angeles, Los Angeles, California., Olyaee M; University of Kansas, Kansas City, Kansas., Pfau P; University of Wisconsin, Madison, Wisconsin., Saligram S; Moffitt Cancer Center, Tampa, Florida., Piraka C; Henry Ford Hospital, Detroit, Michigan., Rastogi A; University of Kansas, Kansas City, Kansas., Rosenkranz L; University of Texas, San Antonio, Texas., Rzouq F; University of Kansas, Kansas City, Kansas., Saxena A; Vanderbilt University, Nashville, Tennessee., Shah RJ; University of Colorado Anschutz Medical Campus, Aurora, Colorado., Simon VC; University of Colorado Anschutz Medical Campus, Aurora, Colorado., Small A; Virginia Mason Medical Center, Seattle, Washington., Sreenarasimhaiah J; University of Texas Southwestern, Dallas, Texas., Walker A; University of Wisconsin, Madison, Wisconsin., Wang AY; University of Virginia Health System, Charlottesville, Virginia., Watson RR; University of California, Los Angeles, Los Angeles, California., Wilson RH; University of Colorado Anschutz Medical Campus, Aurora, Colorado., Yachimski P; Vanderbilt University, Nashville, Tennessee., Yang D; Icahn School of Medicine at Mount Sinai, New York, New York., Edmundowicz S; University of Colorado Anschutz Medical Campus, Aurora, Colorado., Early DS; Washington University School of Medicine, St Louis, Missouri.
Jazyk:	angličtina
Zdroj:	Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] 2017 Nov; Vol. 15 (11), pp. 1758-1767.e11. Date of Electronic Publication: 2017 Jun 16.
DOI:	10.1016/j.cgh.2017.06.012
Abstrakt:	Background & Aims: On the basis of the Next Accreditation System, trainee assessment should occur on a continuous basis with individualized feedback. We aimed to validate endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) learning curves among advanced endoscopy trainees (AETs) by using a large national sample of training programs and to develop a centralized database that allows assessment of performance in relation to peers. Methods: ASGE recognized training programs were invited to participate, and AETs were graded on ERCP and EUS exams by using a validated competency assessment tool that assesses technical and cognitive competence in a continuous fashion. Grading for each skill was done by using a 4-point scoring system, and a comprehensive data collection and reporting system was built to create learning curves by using cumulative sum analysis. Individual results and benchmarking to peers were shared with AETs and trainers quarterly. Results: Of the 62 programs invited, 20 programs and 22 AETs participated in this study. At the end of training, median number of EUS and ERCP performed/AET was 300 (range, 155-650) and 350 (125-500), respectively. Overall, 3786 exams were graded (EUS, 1137; ERCP-biliary, 2280; ERCP-pancreatic, 369). Learning curves for individual end points and overall technical/cognitive aspects in EUS and ERCP demonstrated substantial variability and were successfully shared with all programs. The majority of trainees achieved overall technical (EUS, 82%; ERCP, 60%) and cognitive (EUS, 76%; ERCP, 100%) competence at conclusion of training. Conclusions: These results demonstrate the feasibility of establishing a centralized database to report individualized learning curves and confirm the substantial variability in time to achieve competence among AETs in EUS and ERCP. ClinicalTrials.gov: NCT02509416. (Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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