Prospective study on comparison of simulation-based mastery learning versus conventional apprentice-based learning for basic endoscopy training.

Competency‐based education Curriculum education Endoscopy Mastery learning Simulation training

Journal

Journal of gastroenterology and hepatology
ISSN: 1440-1746
Titre abrégé: J Gastroenterol Hepatol
Pays: Australia
ID NLM: 8607909

Informations de publication

Date de publication:
01 Nov 2024
Historique:
revised: 01 10 2024
received: 31 05 2024
accepted: 22 10 2024
medline: 1 11 2024
pubmed: 1 11 2024
entrez: 1 11 2024
Statut: aheadofprint

Résumé

The simulation-based mastery learning (SBML) method holds promise for improving the efficiency and effectiveness of endoscopy training. However, further study is required to establish its advantages over the traditional method. We aim to prospectively compare outcomes between gastrointestinal endoscopy trainees taught using SBML and those trained using conventional apprenticeship methods for upper endoscopy. We performed a blinded, stepwise, comparative study with SBML participants deliberately practicing deconstructed steps of upper endoscopy and apprenticeship participants observing procedures. Three blinded trainers assessed trainees' skills using a validated esophagogastroduodenoscopy (EGD) tool pre-and post-training. The minimum pass standard (MPS) was set at a score > 2. We compared MPS of the groups using standard statistics and paired t-test. Six trainees were enrolled in the SBML group, and six in the conventional group. All trainees in the SBML group passed the minimum standard compared with the conventional group (P = 0.06). All trainees in the SBML group obtained significantly higher scores in overall basic GI endoscopic skills, esophageal, stomach, and duodenal observation skills than those of the conventional apprenticeship group (P < 0.05). The SBML curriculum led to three times more learning (Cohen's d = 6.5) than the conventional method (Cohen's d = 1.8). This prospective study supports SBML for upper endoscopy training compared with the traditional apprentice-based method. SBML resulted in a steeper learning curve, as trainees learned three times more during the same period. Furthermore, trainees developed a uniform competency level at the end of training.

Sections du résumé

BACKGROUND AND AIM OBJECTIVE
The simulation-based mastery learning (SBML) method holds promise for improving the efficiency and effectiveness of endoscopy training. However, further study is required to establish its advantages over the traditional method. We aim to prospectively compare outcomes between gastrointestinal endoscopy trainees taught using SBML and those trained using conventional apprenticeship methods for upper endoscopy.
METHODS METHODS
We performed a blinded, stepwise, comparative study with SBML participants deliberately practicing deconstructed steps of upper endoscopy and apprenticeship participants observing procedures. Three blinded trainers assessed trainees' skills using a validated esophagogastroduodenoscopy (EGD) tool pre-and post-training. The minimum pass standard (MPS) was set at a score > 2. We compared MPS of the groups using standard statistics and paired t-test.
RESULTS RESULTS
Six trainees were enrolled in the SBML group, and six in the conventional group. All trainees in the SBML group passed the minimum standard compared with the conventional group (P = 0.06). All trainees in the SBML group obtained significantly higher scores in overall basic GI endoscopic skills, esophageal, stomach, and duodenal observation skills than those of the conventional apprenticeship group (P < 0.05). The SBML curriculum led to three times more learning (Cohen's d = 6.5) than the conventional method (Cohen's d = 1.8).
CONCLUSION CONCLUSIONS
This prospective study supports SBML for upper endoscopy training compared with the traditional apprentice-based method. SBML resulted in a steeper learning curve, as trainees learned three times more during the same period. Furthermore, trainees developed a uniform competency level at the end of training.

Identifiants

pubmed: 39484698
doi: 10.1111/jgh.16794
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Author(s). Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Références

BPS‐Statistics Indonesia. Statistical Yearbook of Indonesia 2023 [Internet]. Jakarta: BPS‐Statistics Indonesia, 2023 Available from: https://www.bps.go.id/en/publication/2023/02/28/18018f9896f09f03580a614b/statistical‐yearbook‐of‐indonesia‐2023.html.
Simadibrata M, Adiwinata R. Current issues of gastroenterology in Indonesia. Acta Med. Indones. 2017; 49: 270–278.
Indonesian Society for Digestive Endoscopy. Indonesian Society for Digestive Endoscopy Database. Jakarta; 2023.
Makmun D. Present status of endoscopy, therapeutic endoscopy and the endoscopy training system in Indonesia. Dig. Endosc. 2014; 26: 2–9.
Maulahela H, Annisa NG, Simadibrata M, Syam AF, Findyartini A, Indriatmi W, Soetikno R. Needs assessment of basic gastrointestinal endoscopy training: a qualitative study in Indonesia. JGH Open. 2023; 7: 928–935.
Maulahela H, Annisa NG, Konstantin T, Syam AF, Soetikno R. Simulation‐based mastery learning in gastrointestinal endoscopy training. World J Gastrointest Endosc. 2022; 14: 512–523.
McGaghie WC, Barsuk JH, Wayne DB, eds. Mastery learning: origins, features, and evidence from the health professions. In: Comprehensive Healthcare Simulation: Mastery Learning in Health Professions Education. New York: Springer Nature Switzerland AG, 2020; 27–46.
Soetikno RM, Asokkumar R, Kuwai T et al. WEO international consensus on endoscopy technique: development of a standard operating procedure for EGD using design thinking. Gastrointest. Endosc. 2022; 95: AB62.
Kohn MA, Kenyak J. Sample size calculators [Internet]. UCSF CTSI. 2024. Available from: https://sample‐size.net/sample‐size‐means/
Ritter EM, Taylor ZA, Wolf KR, Franklin BR, Placek SB, Korndorffer JR, Gardner AK. Simulation‐based mastery learning for endoscopy using the endoscopy training system: a strategy to improve endoscopic skills and prepare for the fundamentals of endoscopic surgery (FES) manual skills exam. Surg. Endosc. 2018; 32: 413–420 Available from: https://pubmed.ncbi.nlm.nih.gov/28698900/.
Barsuk JH, Cohen ER, Patel RV et al. Effect of polypectomy simulation‐based mastery learning on skill retention among practicing endoscopists. Acad. Med. 2024; 99: 317–324.
Grover SC, Scaffidi MA, Khan R et al. Progressive learning in endoscopy simulation training improves clinical performance: a blinded randomized trial. Gastrointest. Endosc. 2017; 86: 881–889 Available from: http://www.giejournal.org/article/S0016510717317182/fulltext.

Auteurs

Hasan Maulahela (H)

Division of Gastroenterology, Department of Internal Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Central Jakarta, Indonesia.

Roy M Soetikno (RM)

San Francisco Veteran Affairs Medical Centre, San Francisco, California, USA.

Tonya R Kaltenbach (TR)

San Francisco Veteran Affairs Medical Centre, San Francisco, California, USA.

Nagita Gianty Annisa (NG)

Division of Gastroenterology, Department of Internal Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Central Jakarta, Indonesia.

Nurul Amelia Rahayu Putri (NAR)

Division of Gastroenterology, Department of Internal Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Central Jakarta, Indonesia.

Ari Fahrial Syam (AF)

Division of Gastroenterology, Department of Internal Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Central Jakarta, Indonesia.

Marcellus Simadibrata (M)

Division of Gastroenterology, Department of Internal Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Central Jakarta, Indonesia.

Ardi Findyartini (A)

Department of Medical Education, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.

Wresti Indriatmi (W)

Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.

Classifications MeSH