Colonoscopy Trainers Experience Greater Stress During Insertion than Withdrawal: Implications for Endoscopic Curricula.
Colonoscopy
Endoscopy
Medical education
Simulation
Training
Journal
Journal of the Canadian Association of Gastroenterology
ISSN: 2515-2092
Titre abrégé: J Can Assoc Gastroenterol
Pays: England
ID NLM: 101738684
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
14
08
2019
accepted:
27
09
2019
entrez:
1
3
2021
pubmed:
23
11
2019
medline:
23
11
2019
Statut:
epublish
Résumé
Optimal colonoscopy training curricula should minimize stress and cognitive load. This study aimed to determine whether withdrawal or insertion colonoscopy skills training is associated with less stress or cognitive load for trainees or trainers. In Phase I, participants were randomized to train on either insertion or withdrawal in a simulated environment. In Phase II, participants were randomized to begin with either insertion or withdrawal in patient encounters. Salivary cortisol levels, heart rate, and State-Trait Anxiety Inventory (STAI) surveys were used to assess stress in trainees and trainers. NASA Task Load Index (TLX) survey was used to assess cognitive workload in trainees. In Phase I, trainee stress increased during the simulation training during both withdrawal and insertion compared to baseline, while trainer stress changed minimally. Cognitive load was higher for trainees during withdrawal ( Trainees and trainers exhibit important differences in stress during colonoscopy skills training. Trainees reported more stress during simulation training and greatest cognitive load during simulation withdrawal, whereas trainers reported greatest stress during patient encounters, particularly training of insertion techniques. Attention to the effect of stress on trainees and trainers and the drivers of stress is warranted and could be incorporated in competency based medical education.
Sections du résumé
BACKGROUND
BACKGROUND
Optimal colonoscopy training curricula should minimize stress and cognitive load. This study aimed to determine whether withdrawal or insertion colonoscopy skills training is associated with less stress or cognitive load for trainees or trainers.
METHODS
METHODS
In Phase I, participants were randomized to train on either insertion or withdrawal in a simulated environment. In Phase II, participants were randomized to begin with either insertion or withdrawal in patient encounters. Salivary cortisol levels, heart rate, and State-Trait Anxiety Inventory (STAI) surveys were used to assess stress in trainees and trainers. NASA Task Load Index (TLX) survey was used to assess cognitive workload in trainees.
RESULTS
RESULTS
In Phase I, trainee stress increased during the simulation training during both withdrawal and insertion compared to baseline, while trainer stress changed minimally. Cognitive load was higher for trainees during withdrawal (
CONCLUSION
CONCLUSIONS
Trainees and trainers exhibit important differences in stress during colonoscopy skills training. Trainees reported more stress during simulation training and greatest cognitive load during simulation withdrawal, whereas trainers reported greatest stress during patient encounters, particularly training of insertion techniques. Attention to the effect of stress on trainees and trainers and the drivers of stress is warranted and could be incorporated in competency based medical education.
Identifiants
pubmed: 33644672
doi: 10.1093/jcag/gwz031
pii: gwz031
pmc: PMC7898374
doi:
Types de publication
Journal Article
Langues
eng
Pagination
15-20Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology.
Références
Med Educ. 2016 Jun;50(6):682-92
pubmed: 27170086
J Mot Behav. 2004 Jun;36(2):212-24
pubmed: 15130871
Can J Gastroenterol. 2011 Apr;25(4):198-200
pubmed: 21523260
Gastrointest Endosc. 2010 Dec;72(6):1125-33, 1133.e1-3
pubmed: 21111866
Am J Gastroenterol. 2012 Jul;107(7):971-5
pubmed: 22764019
Can J Gastroenterol. 2010 Dec;24(12):727-32
pubmed: 21165380
Surg Endosc. 2010 Oct;24(10):2556-61
pubmed: 20339876
World J Surg. 2010 Aug;34(8):1756-63
pubmed: 20393847
Gastrointest Endosc. 2017 Nov;86(5):890-891
pubmed: 29061259
Clin Endosc. 2017 Jul;50(4):322-327
pubmed: 28783920
Gastrointest Endosc. 2012 Mar;75(3):591-7
pubmed: 22227035
Gastrointest Endosc. 2017 Nov;86(5):881-889
pubmed: 28366440
Wiley Interdiscip Rev Cogn Sci. 2013 May;4(3):245-261
pubmed: 26304203
Br J Clin Psychol. 1992 Sep;31(3):301-6
pubmed: 1393159
Eur J Gastroenterol Hepatol. 2010 Mar;22(3):368-73
pubmed: 19620875
Psychoneuroendocrinology. 2000 Aug;25(6):535-49
pubmed: 10840167