TITLE

CAN AN INTENSIVE, STRUCTURED TRAINING WEEK IMPROVE COLONOSCOPY PERFORMANCE?

AUTHOR(S)
Thomas-Gibson, S.; Thapar, C.J.; Schofield, G.; Rutter, M.D.; Suzuki, N.; Williams, C.B.; Saunders, B.P.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA33
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: We developed a structured colonoscopy training course aimed at improving technique of trainees with intermediate colonoscopy skills. Methods: 12 specialist registrars (8 surgeons, 4 physicians) attended for a week of comprehensive colonoscopy training and assessment in 3 main areas: core knowledge; two teaching videos; and a CD Rom on colonoscopy/basic polypectomy technique were watched by each trainee. Knowledge was assessed using 2 purpose designed, multiple choice question (MCQ) papers shown to be of equal difficulty. Simulator (hand skills): a mean of 24 (16-31) computer simulator cases were performed. A standardised simulated test case (SSTC) was used to score performance. Clinical skills were taught during 5 training lists by two experts. A mean number of 21 (14-26) clinical cases were performed by each trainee throughout the week. Structured subjective scores using 100 point visual analogue scales were made by both trainers. All assessments were made at the start and end of the week. Results: Eight had performed < 200 cases previously, 4 had performed more than this. The MCQ score significantly increased: mean score 54.8% v 64% (n = 8; p = 0.008). Structured subjective scoring demonstrated an improvement in clinical skill: overall subjective preand post-scores 59.6 v 70.8 (p = 0.0004). Mean total time taken to complete the SSTC improved significantly from 1631 secs pre-training v 1163 secs post-training (p = 0.02). There were no perforations or haemorrhages during the SSTCs and only one vasovagal episode. Discussion: We believe that training must be shown to be effective in achieving its goals. We have demonstrated that a week of structured intensive training can result in an improvement in colonoscopy clinical skills and core knowledge in moderately experienced trainees.
ACCESSION #
9747483

 

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