Evaluating learning curves and competence in colorectal EMR among advanced endoscopy fellows: a pilot multicenter prospective trial using cumulative sum analysis
| Autor: | Juan Carlos Bucobo, Juan E Corral Hurtado, Olumide O. Ajayeoba, Nikhil A. Kumta, Divyesh V. Sejpal, Victoria Gomez, Rebecca J. Beyth, Christopher J. DiMaio, Heiko Pohl, Arvind J. Trindade, Salmaan Jawaid, Andrew Antony, Lionel S. D’Souza, Peter V. Draganov, Yu Wang, Ji-Hyun Lee, Antonio R. Cheesman, Harshit S. Khara, Dushant S. Uppal, Yaseen B. Perbtani, Vineet S. Rolston, Saowanee Ngamruengphong, David L. Diehl, Chris E. Forsmark, Dennis Yang, Andrew Y. Wang, Michael B. Wallace, Amir Rumman |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry MEDLINE Gastroenterology CUSUM Standardized test Cognition Endoscopy 03 medical and health sciences 0302 clinical medicine Learning curve 030220 oncology & carcinogenesis Medicine Humans 030211 gastroenterology & hepatology Radiology Nuclear Medicine and imaging Medical physics Clinical Competence Prospective Studies business Prospective cohort study Colorectal Neoplasms Competence (human resources) Learning Curve |
| Zdroj: | Gastrointestinal endoscopy. 93(3) |
| ISSN: | 1097-6779 |
| Popis: | Background and Aims Data on colorectal EMR (C-EMR) training are lacking. We aimed to evaluate C-EMR training among advanced endoscopy fellows (AEFs) by using a standardized assessment tool (STAT). Methods This multicenter prospective study used a STAT to grade AEF training in C-EMR during their 12-month fellowship. Cumulative sum analysis was used to establish learning curves and competence for cognitive and technical components of C-EMR and overall performance. Sensitivity analysis was performed by varying failure rates. AEFs completed a self-assessment questionnaire to assess their comfort level with performing C-EMR at the completion of their fellowship. Results Six AEFs (189 C-EMRs; mean per AEF, 31.5 ± 18.5) were included. Mean polyp size was 24.3 ± 12.6 mm, and mean procedure time was 22.6 ± 16.1 minutes. Learning curve analyses revealed that less than 50% of AEFs achieved competence for key cognitive and technical C-EMR endpoints. All 6 AEFs reported feeling comfortable performing C-EMR independently at the end of their training, although only 2 of them achieved competence in their overall performance. The minimum threshold to achieve competence in these 2 AEFs was 25 C-EMRs. Conclusions A relatively low proportion of AEFs achieved competence on key cognitive and technical aspects of C-EMR during their 12-month fellowship. The relatively low number of C-EMRs performed by AEFs may be insufficient to achieve competence, in spite of their self-reported readiness for independent practice. These pilot data serve as an initial framework for competence threshold, and suggest the need for validated tools for formal C-EMR training assessment. |
| Databáze: | OpenAIRE |
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