Impact of a simulation-based induction programme in gastroscopy on trainee outcomes and learning curves.

BACKGROUND

Pre-clinical simulation-based training (SBT) in endoscopy has been shown to augment trainee performance in the short-term, but longer-term data are lacking.

AIM

To assess the impact of a two-day gastroscopy induction course combining theory and SBT (Structured PRogramme of INduction and Training - SPRINT) on trainee outcomes over a 16-mo period.

METHODS

This prospective case-control study compared outcomes between novice SPRINT attendees and controls matched from a United Kingdom training database. Study outcomes comprised: (1) Unassisted D2 intubation rates; (2) Procedural discomfort scores; (3) Sedation practice; (4) Time to 200 procedures; and (5) Time to certification.

RESULTS

Total 15 cases and 24 controls were included, with mean procedure counts of 10 and 3 ( = 0.739) pre-SPRINT. Post-SPRINT, no significant differences between the groups were detected in long-term D2 intubation rates ( = 0.332) or discomfort scores ( = 0.090). However, the cases had a significantly higher rate of unsedated procedures than controls post-SPRINT (58% 44%, = 0.018), which was maintained over the subsequent 200 procedures. Cases tended to perform procedures at a greater frequency than controls in the post-SPRINT period (median: 16.2 13.8 per mo, = 0.051), resulting in a significantly greater proportion of cases achieving gastroscopy certification by the end of follow up (75% 36%, = 0.017).

CONCLUSION

In this pilot study, attendees of the SPRINT cohort tended to perform more procedures and achieved gastroscopy certification earlier than controls. These data support the role for wider evaluation of pre-clinical induction involving SBT.