A Prospective Multicenter Study Evaluating Learning Curves and Competence in Endoscopic Ultrasound and Endoscopic Retrograde Cholangiopancreatography Among Advanced Endoscopy Trainees: The Rapid Assessment of Trainee Endoscopy Skills Study

作者：Wani Sachin^*; Keswani Rajesh; Hall Matt; Han Samuel; Ali Meer Akbar; Brauer Brian; Carlin Linda; Chak Amitabh; Collins Dan; Cote Gregory A; Diehl David L; DiMaio Christopher J; Dries Andrew; El Hajj Ihab; Ellert Swan; Fairley Kimberley; Faulx Ashley; Fujii Lau Larissa; Gaddam Srinivas; Gan Seng Ian; Gaspar Jonathan P; Gautamy Chitiki; Gordon Stuart; Harris Cynthia; Hyder Sarah; Jones Ross; Kim Stephen; Komanduri Srinadh; Law Ryan; Lee Linda; Mounzer Rawad

来源：Clinical Gastroenterology and Hepatology, 2017, 15(11): 1758-+.

DOI：10.1016/j.cgh.2017.06.012

• Advanced Endoscopy Training
• Competence
• Competency-based Medical Education
• ERCP
• EUS
• Learning Curves

C BACKGROUND & AIMS: On the basis of the Next Accreditation System, trainee assessment should occur on a continuous basis with individualized feedback. We aimed to validate endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) learning curves among advanced endoscopy trainees (AETs) by using a large national sample of training programs and to develop a centralized database that allows assessment of performance in relation to peers.
METHODS: ASGE recognized training programs were invited to participate, and AETs were graded on ERCP and EUS exams by using a validated competency assessment tool that assesses technical and cognitive competence in a continuous fashion. Grading for each skill was done by using a 4-point scoring system, and a comprehensive data collection and reporting system was built to create learning curves by using cumulative sum analysis. Individual results and benchmarking to peers were shared with AETs and trainers quarterly.
RESULTS: Of the 62 programs invited, 20 programs and 22 AETs participated in this study. At the end of training, median number of EUS and ERCP performed/AET was 300 (range, 155-650) and 350 (125-500), respectively. Overall, 3786 exams were graded (EUS, 1137; ERCP-biliary, 2280; ERCP-pancreatic, 369). Learning curves for individual end points and overall technical/cognitive aspects in EUS and ERCP demonstrated substantial variability and were successfully shared with all programs. The majority of trainees achieved overall technical (EUS, 82%; ERCP, 60%) and cognitive (EUS, 76%; ERCP, 100%) competence at conclusion of training.
CONCLUSIONS: These results demonstrate the feasibility of establishing a centralized database to report individualized learning curves and confirm the substantial variability in time to achieve competence among AETs in EUS and ERCP.

• 出版日期2017-11
• 单位西北大学