The role of endoscopy in inflammatory bowel disease Shergill, Amandeep K., MD; Lightdale, Jenifer R., MD, MPH; Bruining, David H., MD ...
Gastrointestinal endoscopy,
05/2015, Letnik:
81, Številka:
5
Journal Article
Background Minimum training for capsule endoscopy (CE) is based on societal guidelines and expert opinion. Objective measures of competence are lacking. Objectives Our objectives were to (1) ...establish structured CE training curriculum during a gastroenterology fellowship, (2) develop a formalized assessment tool to evaluate CE competency, (3) prospectively analyze trainee CE competency, (4) define metrics for trainee CE competence by using comparative data from CE staff, and (5) determine the correlation between CE competence and previous endoscopy experience. Design Single-center, prospective analysis over 6 years. Setting Tertiary academic center. Subjects Gastroenterology fellows and CE staff. Interventions Structured CE training was implemented with supervised CE interpretation. Capsule Competency Test (CapCT) was developed and data were collected on the number of CEs, upper endoscopies, colonoscopies, and push enteroscopies performed. Main Outcome Measurements Trainee competence defined as CapCT score 90% or higher of the mean staff score. Results A total of 39 fellows completed CE training and CapCT. Fellows were grouped according to number of completed CE interpretations: 10 or fewer (n = 13), 11 to 20 (n = 19), and 21 to 35 (n = 7). Eight CE staff completed CapCT with a mean score of 91%. Mean scores for trainees with fewer than 10, 11 to 20, and 21 to 35 CE interpretations were 79%, 79%, and 85%, respectively. A significant difference was seen between staff and fellow scores with 10 or fewer and 11 to 20 interpretations ( P < .001). No correlation was found between trainee scores and previous endoscopy experience. Limitations Single center. Conclusion Using a structured CE training curriculum, we defined competency in CE interpretation by using the CapCT. Based on these findings, trainees should complete more than 20 CE studies before assessing competence, regardless of previous endoscopy experience.