TY - JOUR
T1 - Effect of individualized feedback on learning curves in EGD and colonoscopy
T2 - a cluster randomized controlled trial
AU - Han, Samuel
AU - Obuch, Joshua C.
AU - Keswani, Rajesh N.
AU - Hall, Matt
AU - Patel, Swati G.
AU - Menard-Katcher, Paul
AU - Simon, Violette
AU - Ezekwe, Eze
AU - Aagaard, Eva
AU - Ahmad, Asyia
AU - Alghamdi, Saad
AU - Austin, Kerri
AU - Brimhall, Bryan
AU - Broy, Charles
AU - Carlin, Linda
AU - Cooley, Matthew
AU - Di Palma, Jack A.
AU - Duloy, Anna M.
AU - Early, Dayna S.
AU - Ellert, Swan
AU - Gaumnitz, Eric A.
AU - Goyal, Jatinder
AU - Kathpalia, Priya
AU - Day, Lukejohn
AU - El-Nachef, Najwa
AU - Kerman, David
AU - Lee, Robert H.
AU - Lunsford, Tisha
AU - Mittal, Mohit
AU - Morigeau, Kirsten
AU - Pietrak, Stanley
AU - Piper, Michael
AU - Shah, Anand S.
AU - Shapiro, Alan B.
AU - Shergill, Amandeep
AU - Sonnier, William
AU - Sorrell, Cari
AU - Vignesh, Shivakumar
AU - Wani, Sachin
N1 - Publisher Copyright:
© 2020 American Society for Gastrointestinal Endoscopy
PY - 2020/4
Y1 - 2020/4
N2 - Background and Aims: Gastroenterology fellowships need to ensure that trainees achieve competence in upper endoscopy (EGD) and colonoscopy. Because the impact of structured feedback remains unknown in endoscopy training, this study compared the effect of structured feedback with standard feedback on trainee learning curves for EGD and colonoscopy. Methods: In this multicenter, cluster, randomized controlled trial, trainees received either individualized quarterly learning curves or feedback standard to their fellowship. Assessment was performed in all trainees using the Assessment of Competency in Endoscopy tool on 5 consecutive procedures after every 25 EGDs and colonoscopies. Individual learning curves were created using cumulative sum (CUSUM) analysis. The primary outcome was the mean CUSUM score in overall technical and overall cognitive skills. Results: In all, 13 programs including 132 trainees participated. The intervention arm (6 programs, 51 trainees) contributed 558 EGD and 600 colonoscopy assessments. The control arm (7 programs, 81 trainees) provided 305 EGD and 468 colonoscopy assessments. For EGD, the intervention arm (–.7 [standard deviation {SD}, 1.3]) had a superior mean CUSUM score in overall cognitive skills compared with the control arm (1.6 [SD,. 8], P = .03) but not in overall technical skills (intervention, –.26 [SD, 1.4]; control, 1.76 [SD,. 7]; P = .06). For colonoscopy, no differences were found between the 2 arms in overall cognitive skills (intervention, –.7 [SD, 1.3]; control,. 7 [SD, 1.3]; P = .95) or overall technical skills (intervention,. 1 [SD, 1.5]; control, –.1 [SD, 1.5]; P = .77). Conclusions: Quarterly feedback in the form of individualized learning curves did not affect learning curves for EGD and colonoscopy in a clinically meaningful manner. (Clinical trial registration number: NCT02891304.)
AB - Background and Aims: Gastroenterology fellowships need to ensure that trainees achieve competence in upper endoscopy (EGD) and colonoscopy. Because the impact of structured feedback remains unknown in endoscopy training, this study compared the effect of structured feedback with standard feedback on trainee learning curves for EGD and colonoscopy. Methods: In this multicenter, cluster, randomized controlled trial, trainees received either individualized quarterly learning curves or feedback standard to their fellowship. Assessment was performed in all trainees using the Assessment of Competency in Endoscopy tool on 5 consecutive procedures after every 25 EGDs and colonoscopies. Individual learning curves were created using cumulative sum (CUSUM) analysis. The primary outcome was the mean CUSUM score in overall technical and overall cognitive skills. Results: In all, 13 programs including 132 trainees participated. The intervention arm (6 programs, 51 trainees) contributed 558 EGD and 600 colonoscopy assessments. The control arm (7 programs, 81 trainees) provided 305 EGD and 468 colonoscopy assessments. For EGD, the intervention arm (–.7 [standard deviation {SD}, 1.3]) had a superior mean CUSUM score in overall cognitive skills compared with the control arm (1.6 [SD,. 8], P = .03) but not in overall technical skills (intervention, –.26 [SD, 1.4]; control, 1.76 [SD,. 7]; P = .06). For colonoscopy, no differences were found between the 2 arms in overall cognitive skills (intervention, –.7 [SD, 1.3]; control,. 7 [SD, 1.3]; P = .95) or overall technical skills (intervention,. 1 [SD, 1.5]; control, –.1 [SD, 1.5]; P = .77). Conclusions: Quarterly feedback in the form of individualized learning curves did not affect learning curves for EGD and colonoscopy in a clinically meaningful manner. (Clinical trial registration number: NCT02891304.)
UR - http://www.scopus.com/inward/record.url?scp=85077147696&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2019.10.032
DO - 10.1016/j.gie.2019.10.032
M3 - Article
C2 - 31715173
AN - SCOPUS:85077147696
SN - 0016-5107
VL - 91
SP - 882-893.e4
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 4
ER -