Impact of a simulation training curriculum on technical and nontechnical skills in colonoscopy: a randomized trial

被引：70

作者：

Grover, Samir C. ^{[1
,3
]}

Garg, Ankit ^{[1
,3
]}

Scaffidi, Michael A. ^{[1
,3
]}

Yu, Jeffrey J. ^{[4
]}

Plener, Ian S. ^{[1
,3
]}

Yong, Elaine ^{[3
,6
]}

Cino, Maria ^{[3
,7
]}

Grantcharov, Teodor P. ^{[2
]}

Walsh, Catharine M. ^{[4
,5
,8
,9
]}

机构：

[1] St Michaels Hosp, Div Gastroenterol, Toronto, ON M5B 1W8, Canada

[2] St Michaels Hosp, Dept Surg, Toronto, ON M5B 1W8, Canada

[3] Univ Toronto, Dept Med, Toronto, ON M5B 1W8, Canada

[4] Univ Toronto, Wilson Ctr, Toronto, ON M5B 1W8, Canada

[5] Univ Toronto, Dept Paediat, Toronto, ON M5B 1W8, Canada

[6] Sunnybrook Hlth Sci Ctr, Div Gastroenterol, Toronto, ON M4N 3M5, Canada

[7] Univ Hlth Network, Div Gastroenterol, Toronto, ON, Canada

[8] Hosp Sick Children, Div Gastroenterol Hepatol & Nutr, Toronto, ON M5G 1X8, Canada

[9] Hosp Sick Children, Learning Inst, Toronto, ON M5G 1X8, Canada

来源：

GASTROINTESTINAL ENDOSCOPY | 2015年 / 82卷 / 06期

关键词：

COMPETENCE ASSESSMENT-TOOL; GASTROINTESTINAL ENDOSCOPY; PROCEDURAL SKILLS; FEEDBACK; GUIDELINES; EDUCATION;

D O I：

10.1016/j.gie.2015.04.008

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: GI endoscopy simulation-based training augments early clinical performance; however, the optimal manner by which to deliver training is unknown. Objective: We aimed to validate a simulation-based structured comprehensive curriculum (SCC) designed to teach technical, cognitive, and integrative competencies in colonoscopy. Design: Single-blinded, randomized, controlled trial. Setting: Endoscopic simulation course at an academic hospital. Participants and Interventions: Thirty-three novice endoscopists were allocated to an SCC group or self-regulated learning (SRL) group. The SCC group received a curriculum consisting of 6 hours of didactic lectures and 8 hours of virtual reality simulation-based training with expert feedback. The SRL group was provided a list of desired objectives and was instructed to practice on the simulator for an equivalent time (8 hours). Main Outcome Measurements: Clinical transfer was assessed during 2 patient colonoscopies using the Joint Advisory Group Direct Observation of Procedural Skills (JAG DOPS) scale. Secondary outcome measures included differences in procedural knowledge, immediate post-training simulation performance, and delayed post-training (4-6 weeks) performance during an integrated scenario test on the JAG DOPS communication and integrated scenario global rating scales. Results: There was no significant difference in baseline or post-training performance on the simulator task. The SCC group performed superiorly during their first and second clinical colonoscopies. Additionally, the SCC group demonstrated significantly better knowledge and colonoscopy-specific performance, communication, and global performance during the integrated scenario. Limitations: We were unable to measure SRL participants' effort outside of mandatory training. In addition, feedback metrics and number of available simulation cases are limited. Conclusions: These results support integration of endoscopy simulation into a structured curriculum incorporating instructional feedback and complementary didactic knowledge as a means to augment technical, cognitive, and integrative skills acquisition, as compared with SRL on virtual reality simulators.

引用

页码：1072 / 1079

页数：8

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