A simple evaluation tool (ET-CET) indicates increase of diagnostic skills from Small bowel capsule endoscopy training courses: A prospective observational european multicenter study

Cristiano Spada, Maria Elena Riccioni, J. G. Albert, O. Humbla, M. E. Mcalindon, C. Davison, U. Seitz, C. Fraser, F. Hagenmüller, E. Noetzel, J. Barnert, N. Filmann, M. Keuchel

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14 Citazioni (Scopus)

Abstract

Small bowel capsule endoscopy (SBCE) has become a first line diagnostic tool. Several training courses with a similar format have been established in Europe; however, data on learning curve and training in SBCE remain sparse. Between 2008 and 2011, different basic SBCE training courses were organized internationally in UK (n=2), Italy (n= 2), Germany (n=2), Finland (n=1), and nationally in Germany (n=10), applying similar 8-hour curricula with 50% lectures and 50% hands-on training. The Given PillCam System was used in 12 courses, the Olympus EndoCapsule system in 5, respectively. A simple evaluation tool for capsule endoscopy training (ET-CET) was developed using 10 short SBCE videos including relevant lesions and normal or irrelevant findings. For each video, delegates were required to record a diagnosis (achievable total score from 0 to 10) and the clinical relevance (achievable total score 0 to 10). ET-CET was performed at baseline before the course and repeated, with videos in altered order, after the course. Two hundred ninety-four delegates (79.3% physicians, 16.3% nurses, 4.4% others) were included for baseline analysis, 268 completed the final evaluation. Forty percent had no previous experience in SBCE, 33% had performed 10 or less procedures. Median scores for correct diagnosis improved from 4.0 (IQR 3) to 7.0 (IQR 3) during the courses (P<0.001, Wilcoxon), and for correct classification of relevance of the lesions from 5.0 (IQR 3) to 7.0 (IQR 3) (P<0.001), respectively. Improvement was not dependent on experience, profession, SBCE system, or course setting. Previous experience in SBCE was associated with higher baseline scores for correct diagnosis (P< 0.001; Kruskal-Wallis). Additionally, independent nonparametric partial correlation with experience in gastroscopy (rho 0.33) and colonoscopy (rho 0.27) was observed (P<0.001). A simple ET-CET demonstrated significant improvement of diagnostic skills on completion of formal basic SBCE courses with hands-on training, regardless of preexisting experience, profession, and course setting. Baseline scores for correct diagnoses show a plateau after interpretation of 25 SBCE before courses, supporting this number as a compromise for credentialing. Experience in flexible endoscopy may be useful before attending an SBCE course.
Lingua originaleEnglish
pagine (da-a)e1941-N/A
RivistaMEDICINE
Volume94
DOI
Stato di pubblicazionePubblicato - 2015

Keywords

  • Capsule Endoscopy
  • Clinical Competence
  • Educational Measurement
  • Europe
  • Humans
  • Intestine, Small
  • Prospective Studies

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