Training in endotherapy for acute upper gastrointestinal bleeding: a UK-wide gastroenterology trainee survey.

bleeding peptic ulcer gastrointestinal bleeding gastrointestinal haemorrhage oesophageal varices

Journal

Frontline gastroenterology
ISSN: 2041-4137
Titre abrégé: Frontline Gastroenterol
Pays: England
ID NLM: 101528589

Informations de publication

Date de publication:
Oct 2020
Historique:
received: 12 10 2019
revised: 02 01 2020
accepted: 20 01 2020
entrez: 26 10 2020
pubmed: 27 10 2020
medline: 27 10 2020
Statut: epublish

Résumé

Competence in endoscopic haemostasis for acute upper gastrointestinal bleeding (AUGIB) is typically expected upon completion of gastroenterology training. However, training in haemostasis is currently variable without a structured training pathway. We conducted a national gastroenterology trainee survey on haemostasis exposure and on attitudes and barriers to training. A 24-item electronic survey was distributed to UK gastroenterology trainees covering the following domains: demographics, training setup, attitudes and barriers, confidence in managing AUGIB independently and exposure to individual haemostatic modalities (supervised and independent). Responses were analysed by region and training grade to assess potential variation in training. A total of 181 trainees completed the questionnaire (response rate 33.5%). There was significant variation in AUGIB training setup across the UK (p<0.001), with 22.7% of trainees declaring no access to structured or ad hoc training. 31.5% expressed confidence in managing AUGIB independently; this varied by trainee grade (0% of first-year specialty trainees (ST3s) to 60.7% of final-years (ST7s)) and by training setup (p=0.001). ST7 trainees reported lack of experience with independently applying glue (86%), Hemospray (54%), heater probe (36%) and variceal banding (36%). Overall, 88% of trainees desired additional haemostasis training and 89% indicated support for a national certification process to ensure competence in AUGIB. AUGIB training in the UK is variable. The majority of gastroenterology trainees lacked confidence in haemostasis management and desired additional training. Training provision should be urgently reviewed to ensure that trainees receive adequate haemostasis exposure and are competent by completion of training.

Identifiants

pubmed: 33104079
doi: 10.1136/flgastro-2019-101345
pii: flgastro-2019-101345
pmc: PMC7569523
doi:

Types de publication

Journal Article

Langues

eng

Pagination

430-435

Informations de copyright

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Références

Frontline Gastroenterol. 2019 Apr;10(2):93-106
pubmed: 31210174
BMJ. 1997 Aug 30;315(7107):510-4
pubmed: 9329304
Frontline Gastroenterol. 2019 Apr;10(2):135-140
pubmed: 31205653
Endosc Int Open. 2016 Mar;4(3):E282-6
pubmed: 27004244
BMJ. 1995 Jul 22;311(6999):222-6
pubmed: 7627034
Frontline Gastroenterol. 2019 Oct;10(4):356-363
pubmed: 31656560
United European Gastroenterol J. 2019 Jul;7(6):798-806
pubmed: 31316784
Cochrane Database Syst Rev. 2018 Aug 17;8:CD008237
pubmed: 30117156
United European Gastroenterol J. 2019 Apr;7(3):449-450
pubmed: 31019713
Frontline Gastroenterol. 2016 Jan;7(1):67-72
pubmed: 28839837
Gut. 2011 Oct;60(10):1327-35
pubmed: 21490373
Endosc Int Open. 2019 Apr;7(4):E551-E560
pubmed: 30957005

Auteurs

Jonathan Segal (J)

Gastroenterology, St Mary's Hospital, London, UK.

Keith Siau (K)

Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK.
Medical and Dental Sciences, University of Birmingham, Birmingham, UK.

Cynthia Kanagasundaram (C)

Luton and Dunstable Hospital NHS Foundation Trust, Luton, UK.

Alan Askari (A)

Department of Surgery, West Hertfordshire Hospitals NHS Trust, Watford, Hertfordshire, UK.

Paul Dunckley (P)

Department of Gastroenterology, Gloucestershire Royal Hospital, Gloucester, Gloucestershire, UK.

Allan John Morris (AJ)

Acute Upper Gastrointestinal Bleeding Endoscopy Quality Improvement Project Lead, British Society of Gastroenterology, London, UK.
Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK.

Classifications MeSH