Impact of a national basic skills in colonoscopy course on trainee performance: An interrupted time series analysis  

作　　者：Keith Siau James Hodson John T Anderson Roland Valori Geoff Smith Paul Hagan Marietta Iacucci Paul Dunckley 

机构地区：[1]Joint Advisory Group on Gastrointestinal Endoscopy,Royal College of Physicians,London NW14LE,United Kingdom [2]NIHR Biomedical Research Centre,University of Birmingham,Birmingham B152TT,United Kingdom [3]Institute of Translational Medicine,University Hospitals Birmingham,Birmingham B152TT,United Kingdom [4]Department of Gastroenterology,Gloucestershire Hospitals NHSFT,Cheltenham GL537AN,United Kingdom [5]Department of Gastroenterology,Imperial College NHS Foundation Trust,London NW14LE,United Kingdom [6]Endoscopy Department,Derby Royal Hospital,Derby GL13NN,United Kingdom

出　　处：《World Journal of Gastroenterology》2020年第23期3283-3292,共10页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND The Joint Advisory Group on Gastrointestinal Endoscopy basic skills in colonoscopy(BSC) course was introduced in 2009 to improve colonoscopy training within the United Kingdom, but its impact on trainee performance is unknown.AIM To assess whether attendance of the BSC could improve colonoscopy performance.METHODS Trainees awarded colonoscopy certification between 2011-2016 were stratified into 3 groups according to pre-course procedure count(< 70, 70-140 and > 140).Study outcomes, comprising the unassisted caecal intubation rate(CIR) and the performance indicator of colonic intubation(PICI), were studied over the 50 procedures pre and post-course. Interrupted time series analyses were performed to detect step-change changes attributable to the course.RESULTS A total of 369 trainees with pre-course procedure counts of < 70(n = 118), 70-140(n = 121) and > 140(n = 130) were included. Over the 50 pre-course procedures,significant linear improvements in CIR were found, with average increases of 4.2,3.6 and 1.7 percentage points(pp) per 10 procedures performed in the < 70, 70-140 and > 140 groups respectively(all P < 0.001). The < 70 procedures group saw a significant step-change improvement in CIR, increasing from 46% in the last pre-course procedure, to 51% in the first procedure post-course(P = 0.005). The CIR step-change was not significant in the 70-140(68% to 71%;P = 0.239) or > 140(86% to 87%;P = 0.354) groups. For PICI, significant step-change improvements were seen in all three groups, with average increases of 5.6 pp(P < 0.001), 5.4 pp(P = 0.003) and 3.9 pp(P = 0.014) respectively.CONCLUSION Attendance of the BSC was associated with a significant step-change improvement in PICI, regardless of prior procedural experience. However, CIR data suggest that the optimal timing of course attendance appears to be at earlier stages of training(< 70 procedures).

关 键 词：COLONOSCOPY Training COURSE Competency development SKILLS ENDOSCOPY 

分 类 号：R574.62[医药卫生—消化系统]