Progressive learning in endoscopy simulation training improves clinical performance: a blinded randomized trial
Autor: | Ian Plener, Maria Cino, Teodor P. Grantcharov, Nikila C. Ravindran, Ahmed Al-Mazroui, Jeffrey J. Yu, Mohamed Al-Awamy, Ankit Garg, Catharine M. Walsh, Michael A. Scaffidi, Samir C. Grover, Elaine L. Yong, Tareq Alomani, Mark Zasowski, Rishad Khan |
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Rok vydání: | 2017 |
Předmět: |
Adult
Male medicine.medical_specialty education MEDLINE Colonoscopy Simulation training law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal Medicine medicine Humans Single-Blind Method Radiology Nuclear Medicine and imaging 030212 general & internal medicine Simulation Training Curriculum medicine.diagnostic_test business.industry Gastroenterology Clinical performance Problem-Based Learning Surgery Endoscopy Clinical trial Education Medical Graduate General Surgery Physical therapy Female 030211 gastroenterology & hepatology Clinical Competence business |
Zdroj: | Gastrointestinal Endoscopy. 86:881-889 |
ISSN: | 0016-5107 0200-0180 |
Popis: | A structured comprehensive curriculum (SCC) that uses simulation-based training (SBT) can improve clinical colonoscopy performance. This curriculum may be enhanced through the application of progressive learning, a training strategy centered on incrementally challenging learners. We aimed to determine whether a progressive learning-based curriculum (PLC) would lead to superior clinical performance compared with an SCC.This was a single-blinded randomized controlled trial conducted at a single academic center. Thirty-seven novice endoscopists were recruited and randomized to either a PLC (n = 18) or to an SCC (n = 19). The PLC comprised 6 hours of SBT, which progressed in complexity and difficulty. The SCC included 6 hours of SBT, with cases of random order of difficulty. Both groups received expert feedback and 4 hours of didactic teaching. Participants were assessed at baseline, immediately after training, and 4 to 6 weeks after training. The primary outcome was participants' performance during their first 2 clinical colonoscopies, as assessed by using the Joint Advisory Group Direct Observation of Procedural Skills assessment tool (JAG DOPS). Secondary outcomes were differences in endoscopic knowledge, technical and communication skills, and global performance in the simulated setting.The PLC group outperformed the SCC group during first and second clinical colonoscopies, measured by JAG DOPS (P .001). Additionally, the PLC group had superior technical and communication skills and global performance in the simulated setting (P .05). There were no differences between groups in endoscopic knowledge (P.05).Our findings demonstrate the superiority of a PLC for endoscopic simulation, compared with an SCC. Challenging trainees progressively is a simple, theory-based approach to simulation whereby the performance of clinical colonoscopies can be improved. (Clinical trial registration number: NCT02000180.). |
Databáze: | OpenAIRE |
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