Competence in Endoscopic Ultrasound and Endoscopic Retrograde Cholangiopancreatography, From Training Through Independent Practice

Abstract

In this prospective multicenter study, we found that although competence cannot be confirmed for all AETs at the end of training, most meet QI thresholds for EUS and ERCP at the end of their first year of independent practice. This finding affirms the effectiveness of training programs. Clinicaltrials.gov ID NCT02509416.

Impact of balloon inflation on the insertion of endoscopic ultrasound: a prospective, randomized controlled trial

“…In this study, pain associated with insertion was reduced and plateaued after 70 procedures and approximately 3 months of experience. Studies of endoscopy learning curves showed that in the case of EUS, a certain level of technical competence was achieved after 50 to 75 procedures [17][18][19]. In this study, a comparable level of technical competence was reached in accordance with previous studies.…”

Setting minimum standards for training in EUS and ERCP: results from a prospective multicenter study evaluating learning curves and competence among advanced endoscopy trainees

“…This approach to assessing learning curves and competence has been widely described in healthcare (cataract surgery, arthroscopy, anesthesia, and endoscopic procedures). 2,[11][12][13][14][15][16][17] Success was defined as a TEESAT score of 1 (no assistance) or 2 (minimal verbal cues) whereas a score of 3 or 4 was considered a failure. For the overall global rating, a score of 3 or 4 represented success.…”

“…7,8 The results of Phase 2, to measure outcomes during the first year of independent practice using established quality indicators in EUS and ERCP for AETP graduates who received continuous structured feedback, have been published separately. 2 Data from Phase 1 were used to address the primary aim of this study. Approval from the Institutional Review Board or the Human Research Protection Office at each site involved was obtained (ClinicalTrials.gov: NCT02509416) and signed informed consent was obtained from all AETs.…”

“…The endpoints used in this tool parallel the key quality metrics established for EUS and ERCP. 7,8,10 Comprehensive data collection and reporting system As we previously described, 2,11 an integrated, comprehensive data collection and reporting system was created to streamline data collection from the participating institutions and apply cumulative sum (CUSUM) analysis. All study participants entered their data on a University of Colorado instance of REDCap, a secure, online database system.…”

“…Given the recent transition from an apprenticeship and time-based model to competency-based medical education (CBME), an outcomes-based approach to the design, implementation, assessment and evaluation of medical education programs using an organizing framework of competencies is needed. 1,2,5 With the ACGME's Next Accreditation System (NAS), the focus has shifted to ensuring that specific milestones are reached throughout training, that competence is achieve by all trainees, and that these assessments are documented by training programs. 6 Although the breadth of training has increased along with an increase in AETPs, there is no fixed mandatory curriculum and no set minimum standards as to what constitutes a "high quality" AETP.…”