Harry J Wong1,2, Mikhail Attaar3,4, Michelle Campbell3,4, Hoover Wu3,4, Kristine Kuchta3, John G Linn3, Stephen P Haggerty3, Woody Denham3, Michael B Ujiki3. 1. Department of Surgery, NorthShore University Health System, 2650 Ridge Ave, GCSI rmB665, Evanston, IL, 60201, USA. Harry.Wong@uchospitals.edu. 2. Department of Surgery, University of Chicago Medicine, Chicago, IL, USA. Harry.Wong@uchospitals.edu. 3. Department of Surgery, NorthShore University Health System, 2650 Ridge Ave, GCSI rmB665, Evanston, IL, 60201, USA. 4. Department of Surgery, University of Chicago Medicine, Chicago, IL, USA.
Abstract
BACKGROUND: Flexible endoscopy is a valuable tool for the gastrointestinal (GI) surgeon, creating a need for effective and efficient training curricula in therapeutic endoscopic techniques for trainees and practicing providers. Here, we present a simulation-based modular curriculum using an "into the fire" approach with hands-on pre- and post-testing to teach endoscopic stenting to practicing surgeons. METHODS: Three advanced flexible endoscopy courses were taught by expert surgical endoscopists from 2018 to 2019. The stenting module involved using self-expandable metal stents to manage simulated esophageal and gastroduodenal strictures on a non-tissue GI model. Based on the educational theories of inquiry-based learning, the simulation curriculum was designed with a series of pre-tests, didactics, mentored hands-on instructions, and post-tests. Assessments included a confidence survey, knowledge-based written test, and evaluation form specific to the hands-on performance of endoscopic stenting. RESULTS: Twenty-eight practicing surgeons with varying endoscopic experiences participated in the course. Most of the participants (67.9%) had completed over 100 upper endoscopic procedures and 57.1% were certified in Fundamentals of Endoscopic Surgery. After completing the modular curriculum, participant confidence survey scores improved from 11.4 ± 4.2 to 20.7 ± 4.0 (p < 0.001). Knowledge-based written test scores also improved from 7.1 ± 1.2 to 8.4 ± 0.9 (p < 0.001). In terms of technical performance, overall hands-on performance scores improved from 21.3 ± 2.7 to 28.9 ± 1.2 (p < 0.001) with significant improvement in each individual component of the assessment (all p values < 0.01) and the greatest improvement seen in equipment handling (88%) and flow of procedure (54%). CONCLUSION: Our modular simulation curriculum using an "into the fire" approach to teach endoscopic stenting is effective in improving learner knowledge, confidence, and hands-on performance of endoscopic stenting. This approach to simulation is effective, efficient, and adaptable to teaching practicing surgeons with varying levels of experience.
BACKGROUND: Flexible endoscopy is a valuable tool for the gastrointestinal (GI) surgeon, creating a need for effective and efficient training curricula in therapeutic endoscopic techniques for trainees and practicing providers. Here, we present a simulation-based modular curriculum using an "into the fire" approach with hands-on pre- and post-testing to teach endoscopic stenting to practicing surgeons. METHODS: Three advanced flexible endoscopy courses were taught by expert surgical endoscopists from 2018 to 2019. The stenting module involved using self-expandable metal stents to manage simulated esophageal and gastroduodenal strictures on a non-tissue GI model. Based on the educational theories of inquiry-based learning, the simulation curriculum was designed with a series of pre-tests, didactics, mentored hands-on instructions, and post-tests. Assessments included a confidence survey, knowledge-based written test, and evaluation form specific to the hands-on performance of endoscopic stenting. RESULTS: Twenty-eight practicing surgeons with varying endoscopic experiences participated in the course. Most of the participants (67.9%) had completed over 100 upper endoscopic procedures and 57.1% were certified in Fundamentals of Endoscopic Surgery. After completing the modular curriculum, participant confidence survey scores improved from 11.4 ± 4.2 to 20.7 ± 4.0 (p < 0.001). Knowledge-based written test scores also improved from 7.1 ± 1.2 to 8.4 ± 0.9 (p < 0.001). In terms of technical performance, overall hands-on performance scores improved from 21.3 ± 2.7 to 28.9 ± 1.2 (p < 0.001) with significant improvement in each individual component of the assessment (all p values < 0.01) and the greatest improvement seen in equipment handling (88%) and flow of procedure (54%). CONCLUSION: Our modular simulation curriculum using an "into the fire" approach to teach endoscopic stenting is effective in improving learner knowledge, confidence, and hands-on performance of endoscopic stenting. This approach to simulation is effective, efficient, and adaptable to teaching practicing surgeons with varying levels of experience.
Authors: Tomokazu Kishiki; Brittany Lapin; Chi Wang; Brandon Jonson; Lava Patel; Matthew Zapf; Matthew Gitelis; Maria A Cassera; Lee L Swanström; Michael B Ujiki Journal: Surg Endosc Date: 2017-09-15 Impact factor: 4.584
Authors: Brenton R Franklin; Sarah B Placek; Aimee K Gardner; James R Korndorffer; Mercy D Wagner; Jonathan P Pearl; E Matthew Ritter Journal: Am J Surg Date: 2017-09-20 Impact factor: 2.565
Authors: Melina C Vassiliou; Brian J Dunkin; Gerald M Fried; John D Mellinger; Thadeus Trus; Pepa Kaneva; Calvin Lyons; James R Korndorffer; Michael Ujiki; Vic Velanovich; Michael L Kochman; Shawn Tsuda; Jose Martinez; Daniel J Scott; Gary Korus; Adrian Park; Jeffrey M Marks Journal: Surg Endosc Date: 2013-11-20 Impact factor: 4.584
Authors: Harry J Wong; Bailey Su; Mikhail Attaar; Kristine Kuchta; John G Linn; Stephen P Haggerty; Woody Denham; Michael B Ujiki Journal: Surg Innov Date: 2021-08-17 Impact factor: 2.058
Authors: Harry J Wong; Bailey Su; Mikhail Attaar; Kristine Kuchta; John G Linn; Woody Denham; Stephen P Haggerty; Michael B Ujiki Journal: Surgery Date: 2020-10-03 Impact factor: 3.982