TY - JOUR

T1 - Computerized feedback during colonoscopy training leads to improved performance

T2 - a randomized trial

AU - Vilmann, Andreas Slot

AU - Norsk, David

AU - Svendsen, Morten Bo Søndergaard

AU - Reinhold, Rasmus

AU - Svendsen, Lars Bo

AU - Park, Yoon Soo

AU - Konge, Lars

N1 - Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

PY - 2018

Y1 - 2018

N2 - BACKGROUND AND AIMS: Simulation-based training in colonoscopy is increasingly replacing the traditional apprenticeship method to avoid patient-related risk. Mentoring during simulation is necessary to provide feedback and to motivate, but expert supervisors are a scarce resource. We aimed to determine whether computerized feedback in simulated colonoscopy would improve performance, optimize time spent practicing, and optimize the pattern of training.METHODS: Forty-four participants were recruited and randomized to either a feedback group (FG) or a control group (CG). Participants were allowed 2 hours of self-practice during which they could practice as they saw fit on 2 different cases: 1 easy and 1 difficult. The CG practiced without feedback, but the participants in the FG were given a score of progression every time they reached the cecum. All participants were tested on a different case after end of training. The primary outcome was the progression score in the final case, and secondary outcomes were time spent practicing and the training pattern.RESULTS: Regression analysis adjusting for sex was done because of an uneven sex distribution between groups (P = .026) and significantly higher performance scores by men (37.6, standard deviation [SD] 25.9) compared with women (19.7, SD 18.7); P = .012. The FG outperformed the CG in the final case, FG scoring 14.4 points (95% confidence interval [CI], 1.2-27.6) more than the CG; P = .033, and they spent more time practicing, FG practicing 25.8 minutes (95% CI, 11.6-39.9) more than the CG; P = .001. The FG practiced more on the easy case and reached the cecum 3.2 times more (95% CI, 2-4.5) during practice (P < .001).CONCLUSIONS: Our findings of this study revealed that an automatic, computerized score of progression during simulated colonoscopy motivates the novices to improve performance, optimizes time spent practicing, and optimizes their pattern of training. (Clinical trial registration number: NCT03248453.).

AB - BACKGROUND AND AIMS: Simulation-based training in colonoscopy is increasingly replacing the traditional apprenticeship method to avoid patient-related risk. Mentoring during simulation is necessary to provide feedback and to motivate, but expert supervisors are a scarce resource. We aimed to determine whether computerized feedback in simulated colonoscopy would improve performance, optimize time spent practicing, and optimize the pattern of training.METHODS: Forty-four participants were recruited and randomized to either a feedback group (FG) or a control group (CG). Participants were allowed 2 hours of self-practice during which they could practice as they saw fit on 2 different cases: 1 easy and 1 difficult. The CG practiced without feedback, but the participants in the FG were given a score of progression every time they reached the cecum. All participants were tested on a different case after end of training. The primary outcome was the progression score in the final case, and secondary outcomes were time spent practicing and the training pattern.RESULTS: Regression analysis adjusting for sex was done because of an uneven sex distribution between groups (P = .026) and significantly higher performance scores by men (37.6, standard deviation [SD] 25.9) compared with women (19.7, SD 18.7); P = .012. The FG outperformed the CG in the final case, FG scoring 14.4 points (95% confidence interval [CI], 1.2-27.6) more than the CG; P = .033, and they spent more time practicing, FG practicing 25.8 minutes (95% CI, 11.6-39.9) more than the CG; P = .001. The FG practiced more on the easy case and reached the cecum 3.2 times more (95% CI, 2-4.5) during practice (P < .001).CONCLUSIONS: Our findings of this study revealed that an automatic, computerized score of progression during simulated colonoscopy motivates the novices to improve performance, optimizes time spent practicing, and optimizes their pattern of training. (Clinical trial registration number: NCT03248453.).

U2 - 10.1016/j.gie.2018.07.008

DO - 10.1016/j.gie.2018.07.008

M3 - Journal article

C2 - 30031803

VL - 88

SP - 869

EP - 876

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 5

ER -