1 research outputs found
Quality assurance of training in diagnostic and therapeutic gastrointestinal endoscopy
Previous evidence has shown that standards of performance in gastrointestinal
endoscopy are variable and that there are disparities in training outcomes. Many
changes have been made recently to both training and assessment of endoscopy in
the UK. However, no prospective methods of evaluating their outcome have been
put in place. The aims of this research were to evaluate current and new training
processes and assessments in order to quality assure the outcomes and improve the
training process. Two audits were undertaken demonstrating improvements in
colonoscopy training over 5 years within a single region and in trainee perceptions of
their training nationally. Two studies were done investigating a novel computer
colonoscopy simulator for assessment of colonoscopic skills, demonstrating
excellent construct validity. A multi-centre randomised controlled trial evaluated the
use of this simulator in novice training, which was shown to be equivalent to
standard bed-side training with a high degree of skills transfer to real-life
colonoscopy. Assessment tools for therapeutic endoscopic procedures were
developed, validated and used to quality assure a course in therapeutic endoscopy.
This course resulted in significant improvements in practical skills for three of the
four therapeutic procedures following training. Web-based training and assessment
modules for lesion recognition at capsule endoscopy were developed, validated and
piloted. This demonstrated the effectiveness of using new training methodologies for
skills improvement in this area. A training course for radiographers in virtual
colonoscopy was developed and the training evaluated. This demonstrated
competence in practical performance and improvements in knowledge and
interpretative skill. Finally, two qualitative studies on non-technical skills in
endoscopy were undertaken in order to widen the assessment domains from purely
knowledge and skill. An interview study provided the basis for development of a nontechnical
skills taxonomy and a video-analysis study resulted in production of a
marker system for professional behaviour within gastrointestinal endoscopy