Introduction Endoscopy is a core component of gastroenterology training[1],yet there are no guidelines on how endoscopists should teach the procedure[2].Across most programs in the USA,endoscopy training follows an ap...Introduction Endoscopy is a core component of gastroenterology training[1],yet there are no guidelines on how endoscopists should teach the procedure[2].Across most programs in the USA,endoscopy training follows an apprenticeship model,in which trainees develop skills through supervised,hands-on practice[3].Although some programs use assessment tools to determine proficiency in performing endoscopy procedures,most rely principally on procedural volume and subjective evaluations.As a result,endoscopic training is variable across and within institutions.展开更多
Background:Attending assessment is a critical part of endoscopic education for gastroenterology fellows.The aim of this study was to develop and validate a concise,web-based assessment tool to evaluate real-time fello...Background:Attending assessment is a critical part of endoscopic education for gastroenterology fellows.The aim of this study was to develop and validate a concise,web-based assessment tool to evaluate real-time fellow performance in upper endoscopy.Methods:We developed the Skill Assessment in Fellow Endoscopy Training(SAFE-T)upper endoscopy tool to capture both summative and formative feedback in a concise,five-part questionnaire.The tool mirrors the previously validated SAFE-T colonoscopy tool and is administered electronically via a web-based application.We evaluated the tool in a prospective study of 15 gastroenterology fellows(5 fellows each from Years 1–3 of training)over the 2018–2019 academic year.An independent reviewer evaluated a subset of these procedures and completed both the SAFE-T and Assessment of Competency in Endoscopy(ACE)upper endoscopy forms for reliability testing.Results:Twenty faculty completed 413 SAFE-T evaluations of the 15 fellows in the study.The mean SAFE-T overall score differentiated each sequential fellow year of training,with first-year cases having lower performance than second-year cases(3.31 vs 4.25,P<0.001)and second-year cases having lower performance than third-year cases(4.25 vs 4.56,P<0.001).The mean SAFE-T overall score decreased with increasing case-complexity score,with straightforward compared with average cases(3.98 vs 3.39,P<0.001)and average compared with challenging cases(3.39 vs 2.84,P=0.042).In dual-observed procedures,the SAFE-T tool showed excellent inter-rater reliability with a Kappa agreement statistic of 0.815(P=0.001).The SAFE-T overall score also highly correlated with the ACE upper endoscopy overall hands-on score(r=0.76,P=0.011).Conclusions:We developed and validated the SAFE-T upper endoscopy tool—a concise and web-based means of assessing real-time gastroenterology fellow performance in upper endoscopy.展开更多
Introduction One of the key objectives of gastroenterology(GI)fellowships is to teach fellows how to perform high-quality endoscopic procedures[1].The primary model for this education is the apprenticeship approach,in...Introduction One of the key objectives of gastroenterology(GI)fellowships is to teach fellows how to perform high-quality endoscopic procedures[1].The primary model for this education is the apprenticeship approach,in which fellows perform endoscopic procedures on patients under the supervision of an attending gastroenterologist[2].Critical to the success of this teaching model,faculty should deliver timely and actionable feedback based on direct observation of the fellow’s endoscopic performance[3].展开更多
基金supported by the Clinical Education Research Scholars Program of the Department of Medicine at Brigham and Women’s Hospital(award recipient—Navin L.Kumar).
文摘Introduction Endoscopy is a core component of gastroenterology training[1],yet there are no guidelines on how endoscopists should teach the procedure[2].Across most programs in the USA,endoscopy training follows an apprenticeship model,in which trainees develop skills through supervised,hands-on practice[3].Although some programs use assessment tools to determine proficiency in performing endoscopy procedures,most rely principally on procedural volume and subjective evaluations.As a result,endoscopic training is variable across and within institutions.
基金supported by the Clinical Education Research Scholars Program of the Department of Medicine at Brigham and Women’s Hospital(award recipient—N.L.K.)the NIH T32 training grant(DK007533035,award recipient—K.E.H.).
文摘Background:Attending assessment is a critical part of endoscopic education for gastroenterology fellows.The aim of this study was to develop and validate a concise,web-based assessment tool to evaluate real-time fellow performance in upper endoscopy.Methods:We developed the Skill Assessment in Fellow Endoscopy Training(SAFE-T)upper endoscopy tool to capture both summative and formative feedback in a concise,five-part questionnaire.The tool mirrors the previously validated SAFE-T colonoscopy tool and is administered electronically via a web-based application.We evaluated the tool in a prospective study of 15 gastroenterology fellows(5 fellows each from Years 1–3 of training)over the 2018–2019 academic year.An independent reviewer evaluated a subset of these procedures and completed both the SAFE-T and Assessment of Competency in Endoscopy(ACE)upper endoscopy forms for reliability testing.Results:Twenty faculty completed 413 SAFE-T evaluations of the 15 fellows in the study.The mean SAFE-T overall score differentiated each sequential fellow year of training,with first-year cases having lower performance than second-year cases(3.31 vs 4.25,P<0.001)and second-year cases having lower performance than third-year cases(4.25 vs 4.56,P<0.001).The mean SAFE-T overall score decreased with increasing case-complexity score,with straightforward compared with average cases(3.98 vs 3.39,P<0.001)and average compared with challenging cases(3.39 vs 2.84,P=0.042).In dual-observed procedures,the SAFE-T tool showed excellent inter-rater reliability with a Kappa agreement statistic of 0.815(P=0.001).The SAFE-T overall score also highly correlated with the ACE upper endoscopy overall hands-on score(r=0.76,P=0.011).Conclusions:We developed and validated the SAFE-T upper endoscopy tool—a concise and web-based means of assessing real-time gastroenterology fellow performance in upper endoscopy.
基金This work was supported by the Clinical Education Research Scholars Program of the Department of Medicine at Brigham and Women’s Hospital(award recipient-Navin L.Kumar)。
文摘Introduction One of the key objectives of gastroenterology(GI)fellowships is to teach fellows how to perform high-quality endoscopic procedures[1].The primary model for this education is the apprenticeship approach,in which fellows perform endoscopic procedures on patients under the supervision of an attending gastroenterologist[2].Critical to the success of this teaching model,faculty should deliver timely and actionable feedback based on direct observation of the fellow’s endoscopic performance[3].
