ePoster
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Presentation Description
Robert Sedlack1
1 Mayo Clinic, Rochester MN, USA
1 Mayo Clinic, Rochester MN, USA
Background & Aims:
In the United States, general surgical residents are required to complete 50 colonoscopies during training.[1] This is felt to be inadequately low by most in the gastroenterology (GI) community, as GI fellows have been repeatedly shown to require on average 250-275 colonoscopies to achieve defined competency thresholds as measured by the Assessment of Competency in Endoscopy (ACE) evaluation tool.[2] This study defines the learning curves of surgical trainees using the ACE tool to determine if CRS fellows can indeed achieve the same competency thresholds earlier.
In the United States, general surgical residents are required to complete 50 colonoscopies during training.[1] This is felt to be inadequately low by most in the gastroenterology (GI) community, as GI fellows have been repeatedly shown to require on average 250-275 colonoscopies to achieve defined competency thresholds as measured by the Assessment of Competency in Endoscopy (ACE) evaluation tool.[2] This study defines the learning curves of surgical trainees using the ACE tool to determine if CRS fellows can indeed achieve the same competency thresholds earlier.
Methods:
In a single center, retrospective descriptive study, 6 years of ACE scores were examined from colonoscopies performed by CRS fellows. Average scores were calculated at intervals of every 25 procedures, and the learning curves described for each metric measured by the ACE tool.
In a single center, retrospective descriptive study, 6 years of ACE scores were examined from colonoscopies performed by CRS fellows. Average scores were calculated at intervals of every 25 procedures, and the learning curves described for each metric measured by the ACE tool.
Results:
17 CRS fellows (M:F 11:6) had an average experience of 108 colonoscopies (range 50-266) prior to CRS fellowship. During fellowship, an average of 138 colonoscopies (range 116 -173) were recorded. Most ACE metrics reached the defined competency thresholds around 300 to 350 procedures.
17 CRS fellows (M:F 11:6) had an average experience of 108 colonoscopies (range 50-266) prior to CRS fellowship. During fellowship, an average of 138 colonoscopies (range 116 -173) were recorded. Most ACE metrics reached the defined competency thresholds around 300 to 350 procedures.
Conclusion:
No CRS fellow had achieved the competency thresholds for any ACE metric at the onset of fellowship despite an average of over 100 procedures experience. On average, CRS fellows reached competency in colonoscopy around 300 to 350 procedures of experience, a trajectory similar to slightly delayed compared to previously reported averages for GI fellows. These results call into question the required procedure volumes recommended in surgery training guidelines for colonoscopy.
No CRS fellow had achieved the competency thresholds for any ACE metric at the onset of fellowship despite an average of over 100 procedures experience. On average, CRS fellows reached competency in colonoscopy around 300 to 350 procedures of experience, a trajectory similar to slightly delayed compared to previously reported averages for GI fellows. These results call into question the required procedure volumes recommended in surgery training guidelines for colonoscopy.
References (maximum three)
[1] Vassiliou MC, Kaneva PA, Poulose BK, et al. How should we establish the clinical case numbers required to achieve proficiency in flexible endoscopy? Am J Surg 2010;199:121-5.
[2] Sedlack RE, Coyle WJ, ACE Research Group. Assessment of competency in endoscopy: establishing and validating generalizable competency benchmarks for colonoscopy. Gastrointest Endosc 2016;83: 524-526.