| Strategies for training in diagnostic upper endoscopy: a prospective, randomized trial. | |
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MedLine Citation:
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PMID: 22153875 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Training simulators have been used for decades with success; however, a standardized educational strategy for diagnostic EGD is still lacking. OBJECTIVE: Development of a training strategy for diagnostic upper endoscopy. STUDY DESIGN: Prospective, randomized trial. SETTINGS: A total of 28 medical and surgical residents without endoscopic experience were enrolled. Basic skills evaluations were performed after a structured program involving theoretical lectures and a hands-on course in diagnostic EGD. Subsequently, stratified randomization to clinical plus simulator training (group 1, n = 10), clinical training only (group 2, n = 9), or simulator training only (group 3, n = 9) was performed. Ten sessions of simulator training (Simbionix, compactEASIE, plastic phantom) were conducted for groups 1 and 3 during the 4-month program. Group 2 underwent standard training in endoscopy without supplemental simulator training. The final evaluation was performed on the simulator and by observation of 3 clinical cases. Skills and procedural times were recorded by blinded and unblinded evaluators. MAIN OUTCOME MEASUREMENTS: Time to reach the duodenum, pylorus, or esophagus. RESULTS: All trainees demonstrated a significant reduction in procedure time during a simple manual skills test (P < .05) and significantly better skills scores (P = .006, P = .042 and P = .017) in the simulator independent of the training strategy. Group 1 showed shorter times to intubate the esophagus (61 ± 26 seconds vs 85 ± 30 seconds and 95 ± 36 seconds) and the pylorus (183 ± 65 seconds vs 207 ± 61 seconds and 247 ± 66 seconds) during the clinical evaluation. Blinded assessment of EGD skills showed significantly better results for group 1 compared with group 3. Blinded and unblinded evaluations were not statistically different. LIMITATIONS: Small sample size. CONCLUSIONS: Structured simulator training supplementing clinical training in upper endoscopy appears to be superior to clinical training alone. Simulator training alone does not seem to be sufficient to improve endoscopic skills. |
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Authors:
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Anke Ende; Yurdaguel Zopf; Peter Konturek; Andreas Naegel; Eckhart G Hahn; Kai Matthes; Juergen Maiss |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-6 |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: - ISSN: 1097-6779 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Medicine, University of Erlangen-Nuremberg, Erlangen, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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