Randomized controlled trial of self-directed versus in-classroom teaching of narrow-band imaging for diagnosis of Barrett's esophagus-associated neoplasia.
Gastrointest Endosc
; 83(1): 101-6, 2016 Jan.
Article
em En
| MEDLINE
| ID: mdl-26272857
ABSTRACT
BACKGROUND AND AIMS:
Previous studies have shown that narrow-band imaging (NBI) can be taught to inexperienced gastroenterologists. However, it is unknown whether in-person training is more effective than self-directed training. The objective of this study was to compare the accuracy of diagnosing Barrett's esophagus (BE)-associated neoplasia by trainees with no prior NBI experience between in-classroom and self-directed didactic training programs.METHODS:
This was a randomized controlled trial that took place at 2 tertiary-care medical centers, involving 33 participants--12 second-year medical students, 8 first-year gastroenterology fellows, 7 second-year gastroenterology fellows, and 6 third-year gastroenterology fellows. A teaching module was developed for all participants to review. Half of the participants were taught in a classroom setting by an endoscopist with expertise in NBI, whereas the other participants were in a self-directed group that received an automated version of the presentation with audio commentary. Participants completed a test of 40 randomized NBI images, predicting the histology and indicating their confidence levels in the diagnosis.RESULTS:
There was no difference in accuracy between the in-classroom and self-directed groups (57.5% vs 57.2%; P = 1.0). The in-classroom group had a significantly higher percentage of high-confidence answers (57.2% vs 41.1%; P ≤ .01), but there was no significant difference in accuracy with these high-confidence answers (60.7% vs 66.4%; P = .34). There was no significant difference in overall accuracy or accuracy with high-confidence predictions between the 2 study sites (57.4% vs 55.9%, P = .58; 63.1% vs 61.4%, P = .69) or between gastroenterology fellows and medical students (57.8% vs 54.6%, P = .27; 62.8% vs 60.8%, P = .62).CONCLUSIONS:
The overall accuracy of predicting NBI patterns in BE were modest in our study participants, and there was no difference between self-directed and in-classroom didactic training. Self-directed learning of NBI is adequate for teaching NBI to trainees.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Instruções Programadas como Assunto
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Esôfago de Barrett
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Neoplasias Esofágicas
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Adenocarcinoma
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Esofagoscopia
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Educação Médica
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Imagem de Banda Estreita
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Gastroenterologia
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Gastrointest Endosc
Ano de publicação:
2016
Tipo de documento:
Article