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Progressive learning in endoscopy simulation training improves clinical performance: a blinded randomized trial.

Abstract：

BACKGROUND AND AIMS: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. METHODS: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. RESULTS: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). CONCLUSIONS: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.).

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Grover SC,Scaffidi MA,Khan R,Garg A,Al-Mazroui A,Alomani T,Yu JJ,Plener IS,Al-Awamy M,Yong EL,Cino M,Ravindran NC,Zasowski M,Grantcharov TP,Walsh CM

doi

10.1016/j.gie.2017.03.1529

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

881-889

issue

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(17)31718-2

journal_volume

pub_type

杂志文章,随机对照试验

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Progressive learning in endoscopy simulation training improves clinical performance: a blinded randomized trial.