Samir C Grover1, Michael A Scaffidi1, Rishad Khan1, Ankit Garg1, Ahmed Al-Mazroui1, Tareq Alomani1, Jeffrey J Yu2, Ian S Plener1, Mohamed Al-Awamy1, Elaine L Yong3, Maria Cino4, Nikila C Ravindran1, Mark Zasowski1, Teodor P Grantcharov5, Catharine M Walsh2. 1. Division of Gastroenterology, St. Michael's Hospital Department of Medicine, University of Toronto, Toronto, Ontario, Canada. 2. Division of Gastroenterology, Hepatology, and Nutrition, Learning Institute, and Research Institute, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; The Wilson Centre, University of Toronto, Toronto, Ontario, Canada. 3. Division of Gastroenterology, Sunnybrook Hospital, University of Toronto, Toronto, Ontario, Canada. 4. Division of Gastroenterology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada. 5. Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
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.).
RCT Entities:
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.).
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: 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
Authors: Rishad Khan; Parul Tandon; Michael A Scaffidi; Kirles Bishay; Katarzyna M Pawlak; Jan Kral; 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; Keith Siau; Catharine M Walsh; Samir C Grover Journal: J Can Assoc Gastroenterol Date: 2020-10-24
Authors: João Victor Taba; Vitor Santos Cortez; Walter Augusto Moraes; Leandro Ryuchi Iuamoto; Wu Tu Hsing; Milena Oliveira Suzuki; Fernanda Sayuri do Nascimento; Leonardo Zumerkorn Pipek; Vitoria Carneiro de Mattos; Eugênia Carneiro D'Albuquerque; Luiz Augusto Carneiro-D'Albuquerque; Alberto Meyer; Wellington Andraus Journal: PLoS One Date: 2021-06-17 Impact factor: 3.240