Samir C Grover1, Ankit Garg1, Michael A Scaffidi1, Jeffrey J Yu2, Ian S Plener1, Elaine Yong3, Maria Cino4, Teodor P Grantcharov5, Catharine M Walsh6. 1. Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada. 2. Wilson Centre, University of Toronto, Toronto, Ontario, Canada. 3. Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Gastroenterology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. 4. Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Gastroenterology, University Health Network, Toronto, Ontario, Canada. 5. Department of Surgery, St. Michael's Hospital, Toronto, Ontario, Canada. 6. Wilson Centre, University of Toronto, Toronto, Ontario, Canada; Division of Gastroenterology, Hepatology and Nutrition, and the Learning Institute, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
Abstract
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. ( CLINICAL TRIAL REGISTRATION NUMBER: NCT01991522.)
RCT Entities:
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. ( CLINICAL TRIAL REGISTRATION NUMBER: NCT01991522.)
Authors: Mia Louise Østergaard; Kristina Rue Nielsen; Elisabeth Albrecht-Beste; Annette Kjær Ersbøll; Lars Konge; Michael Bachmann Nielsen Journal: Eur Radiol Date: 2019-01-07 Impact factor: 5.315
Authors: Rishad Khan; Joanne Plahouras; Bradley C Johnston; Michael A Scaffidi; Samir C Grover; Catharine M Walsh Journal: Cochrane Database Syst Rev Date: 2018-08-17
Authors: Rishad Khan; Michael A Scaffidi; Catharine M Walsh; Peter Lin; Ahmed Al-Mazroui; Barinder Chana; Ruben Kalaichandran; Woojin Lee; Teodor P Grantcharov; Samir C Grover Journal: JMIR Res Protoc Date: 2017-08-04
Authors: Michael A Scaffidi; Catharine M Walsh; Rishad Khan; Colleen H Parker; Ahmed Al-Mazroui; Michael Abunassar; Alexander W Grindal; Peter Lin; Christopher Wang; Robert Bechara; Samir C Grover Journal: Endosc Int Open Date: 2019-05-03
Authors: Katarzyna M Pawlak; Jan Kral; Rishad Khan; Sunil Amin; Mohammad Bilal; Rashid N Lui; Dalbir S Sandhu; Almoutaz Hashim; Steven Bollipo; Aline Charabaty; Enrique de-Madaria; Andrés F Rodríguez-Parra; Sergio A Sánchez-Luna; Michał Żorniak; Catharine M Walsh; Samir C Grover; Keith Siau Journal: Gastrointest Endosc Date: 2020-06-11 Impact factor: 9.427