Anna M Duloy1, Tonya R Kaltenbach2, Mariah Wood3, Dyanna L Gregory3, Rajesh N Keswani3. 1. Department of Gastroenterology and Hepatology, University of Colorado, Aurora, Colorado, USA. 2. Department of Gastroenterology, University of California, San Francisco, San Francisco, California, USA. 3. Department of Gastroenterology and Hepatology, Northwestern University, Chicago, Illinois, USA.
Abstract
BACKGROUND AND AIMS: Polypectomy competency varies significantly among providers. Poor polypectomy technique may lead to interval cancer and/or adverse events. Our aim was to determine the effect of a polypectomy skills report card on subsequent polypectomy performance. METHODS: We conducted a 3-phase, prospective, single-blinded study. In phase 1 ("baseline"), we graded 10 polypectomies per endoscopist using the Direct Observation of Polypectomy Skills (DOPyS) tool (scores 1-4); mean overall scores ≥3 are competent. In phase 2 ("pre-report card"), we selected 10 additional polypectomies per endoscopist. We subsequently gave endoscopists a report card with baseline scores and instructional videos demonstrating optimal polypectomy technique. In phase 3 ("post-report card"), 10 additional polypectomies per endoscopist were selected. Raters, blinded to study phase, graded 10 pre- and 10 post-report card polypectomies per endoscopist. We compared mean DOPyS scores and rate of competent polypectomy in the pre- and post-report card phases. RESULTS: We graded 110 pre- and 110 post-report card polypectomies performed by 11 endoscopists. The mean DOPyS score increased between the pre- and post-report card phases (2.7 ± .9 vs 3.0 ± .8, P = .01); this improvement was seen for diminutive (P < .0001) but not for small-to-large polyps. Rate of competent polypectomy significantly improved from the pre- to post-report card phase (56% vs 69%, P = .04); this improvement was seen for diminutive (57% vs 81%, P = .001) but not for small-to-large polyps (55% vs 36%, P = .2). CONCLUSIONS: Report cards with educational videos effectively improved polypectomy technique, primarily because of improvements in resecting diminutive polyps. The improved competency and decreased piecemeal resection may reduce the risk of polyp recurrence. Further education is needed to improve larger polyp resection.
BACKGROUND AND AIMS: Polypectomy competency varies significantly among providers. Poor polypectomy technique may lead to interval cancer and/or adverse events. Our aim was to determine the effect of a polypectomy skills report card on subsequent polypectomy performance. METHODS: We conducted a 3-phase, prospective, single-blinded study. In phase 1 ("baseline"), we graded 10 polypectomies per endoscopist using the Direct Observation of Polypectomy Skills (DOPyS) tool (scores 1-4); mean overall scores ≥3 are competent. In phase 2 ("pre-report card"), we selected 10 additional polypectomies per endoscopist. We subsequently gave endoscopists a report card with baseline scores and instructional videos demonstrating optimal polypectomy technique. In phase 3 ("post-report card"), 10 additional polypectomies per endoscopist were selected. Raters, blinded to study phase, graded 10 pre- and 10 post-report card polypectomies per endoscopist. We compared mean DOPyS scores and rate of competent polypectomy in the pre- and post-report card phases. RESULTS: We graded 110 pre- and 110 post-report card polypectomies performed by 11 endoscopists. The mean DOPyS score increased between the pre- and post-report card phases (2.7 ± .9 vs 3.0 ± .8, P = .01); this improvement was seen for diminutive (P < .0001) but not for small-to-large polyps. Rate of competent polypectomy significantly improved from the pre- to post-report card phase (56% vs 69%, P = .04); this improvement was seen for diminutive (57% vs 81%, P = .001) but not for small-to-large polyps (55% vs 36%, P = .2). CONCLUSIONS: Report cards with educational videos effectively improved polypectomy technique, primarily because of improvements in resecting diminutive polyps. The improved competency and decreased piecemeal resection may reduce the risk of polyp recurrence. Further education is needed to improve larger polyp resection.
Authors: Gregory A Coté; B Joseph Elmunzer; Erin Forster; Robert A Moran; John G Quiles; Daniel S Strand; Dushant S Uppal; Andrew Y Wang; Peter B Cotton; Michael G McMurtry; James M Scheiman Journal: Tech Innov Gastrointest Endosc Date: 2021-01-18
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Authors: Rajesh N Keswani; Mariah Wood; Mark Benson; Andrew J Gawron; Charles Kahi; Tonya Kaltenbach; Rena Yadlapati; Dyanna Gregory; Anna Duloy Journal: Endosc Int Open Date: 2022-03-14
Authors: B Joseph Elmunzer; Catharine M Walsh; Gretchen Guiton; Jose Serrano; Amitabh Chak; Steven Edmundowicz; Richard S Kwon; Daniel Mullady; Georgios I Papachristou; Grace Elta; Todd H Baron; Patrick Yachimski; Evan L Fogel; Peter V Draganov; Jason R Taylor; James Scheiman; Vikesh K Singh; Shyam Varadarajulu; Field F Willingham; Gregory A Cote; Peter B Cotton; Violette Simon; Rebecca Spitzer; Rajesh Keswani; Sachin Wani Journal: Gastrointest Endosc Date: 2020-07-30 Impact factor: 9.427