TY - JOUR
T1 - Structured training program on confocal laser endomicroscopy for pancreatic cystic lesions
T2 - a multicenter prospective study among early-career endosonographers (with video)
AU - Machicado, Jorge D.
AU - Napoleon, Bertrand
AU - Akshintala, Venkata
AU - Bazarbashi, Ahmad Najdat
AU - Bilal, Mohammad
AU - Corral, Juan E.
AU - Dugum, Mohannad
AU - Han, Samuel
AU - Hussain, Farah S.
AU - Johnson, Alyson M.
AU - Jovani, Manol
AU - Kolb, Jennifer M.
AU - Leonor, Paul
AU - Lee, Peter J.
AU - Mulki, Ramzi
AU - Shah, Hamza
AU - Singh, Harkirat
AU - Sánchez-Luna, Sergio A.
AU - Shah, Shawn L.
AU - Singla, Anand
AU - Vargas, Eric J.
AU - Tielleman, Thomas
AU - Nikahd, Melica
AU - Fry, Megan
AU - Culp, Stacey
AU - Krishna, Somashekar G.
N1 - Publisher Copyright:
© 2023 American Society for Gastrointestinal Endoscopy
PY - 2023/12
Y1 - 2023/12
N2 - Background and Aims: Data on how to teach endosonographers needle-based confocal laser endomicroscopy (nCLE)-guided histologic diagnosis of pancreatic cystic lesions (PCLs) are limited. Hence, we developed and tested a structured educational program to train early-career endosonographers in nCLE-guided diagnosis of PCLs. Methods: Twenty-one early-career nCLE-naïve endosonographers watched a teaching module outlining nCLE criteria for diagnosing PCLs. Participants then reviewed 80 high-yield nCLE videos, recorded diagnoses, and received expert feedback (phase 1). Observers were then randomized to a refresher feedback session or self-learning at 4 weeks. Eight weeks after training, participants independently assessed the same 80 nCLE videos without feedback and provided histologic predictions (phase 2). Diagnostic performance of nCLE to differentiate mucinous versus nonmucinous PCLs and to diagnose specific subtypes were analyzed using histopathology as the criterion standard. Learning curves were determined using cumulative sum analysis. Results: Accuracy and diagnostic confidence for differentiating mucinous versus nonmucinous PCLs improved as endosonographers progressed through nCLE videos in phase 1 (P < .001). Similar trends were observed with the diagnosis of PCL subtypes. Most participants achieved competency interpreting nCLE, requiring a median of 38 assessments (range, 9-67). During phase 2, participants independently differentiated PCLs with high accuracy (89%), high confidence (83%), and substantial interobserver agreement (κ = .63). Accuracy for nCLE-guided PCL subtype diagnoses ranged from 82% to 96%. The learned nCLE skills did not deteriorate at 8 weeks and were not impacted by a refresher session. Conclusions: We developed a practical, effective, and durable educational intervention to train early-career endosonographers in nCLE-guided diagnosis of PCLs.
AB - Background and Aims: Data on how to teach endosonographers needle-based confocal laser endomicroscopy (nCLE)-guided histologic diagnosis of pancreatic cystic lesions (PCLs) are limited. Hence, we developed and tested a structured educational program to train early-career endosonographers in nCLE-guided diagnosis of PCLs. Methods: Twenty-one early-career nCLE-naïve endosonographers watched a teaching module outlining nCLE criteria for diagnosing PCLs. Participants then reviewed 80 high-yield nCLE videos, recorded diagnoses, and received expert feedback (phase 1). Observers were then randomized to a refresher feedback session or self-learning at 4 weeks. Eight weeks after training, participants independently assessed the same 80 nCLE videos without feedback and provided histologic predictions (phase 2). Diagnostic performance of nCLE to differentiate mucinous versus nonmucinous PCLs and to diagnose specific subtypes were analyzed using histopathology as the criterion standard. Learning curves were determined using cumulative sum analysis. Results: Accuracy and diagnostic confidence for differentiating mucinous versus nonmucinous PCLs improved as endosonographers progressed through nCLE videos in phase 1 (P < .001). Similar trends were observed with the diagnosis of PCL subtypes. Most participants achieved competency interpreting nCLE, requiring a median of 38 assessments (range, 9-67). During phase 2, participants independently differentiated PCLs with high accuracy (89%), high confidence (83%), and substantial interobserver agreement (κ = .63). Accuracy for nCLE-guided PCL subtype diagnoses ranged from 82% to 96%. The learned nCLE skills did not deteriorate at 8 weeks and were not impacted by a refresher session. Conclusions: We developed a practical, effective, and durable educational intervention to train early-career endosonographers in nCLE-guided diagnosis of PCLs.
UR - http://www.scopus.com/inward/record.url?scp=85174452507&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2023.07.019
DO - 10.1016/j.gie.2023.07.019
M3 - Article
C2 - 37473969
AN - SCOPUS:85174452507
SN - 0016-5107
VL - 98
SP - 953
EP - 964
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 6
ER -