Training in endoscopic mucosal resection: effectiveness and clinical utility of a short course for practicing endoscopists

TL;DR

A one-day training course significantly improves endoscopists' knowledge and skills in endoscopic mucosal resection, with lasting benefits.

Contribution

A short, simulation-based EMR training course is shown to be effective and clinically useful for practicing endoscopists.

Findings

Participants showed significant improvement in knowledge scores after the course.

Knowledge retention was maintained 10-14 weeks post-training.

Interviews revealed improved EMR technique and perceived need for training.

Abstract

Endoscopic mucosal resection (EMR) is not systematically taught during most training programs. The aim of this study was to evaluate the effectiveness and clinical utility of a 1-day didactic and simulation-based EMR curriculum for practicing endoscopists without prior formal training in advanced endoscopic tissue resection.

We designed a 1-day lecture and simulation-based EMR course. Twelve participants completed the course. Effectiveness and clinical utility were evaluated using sequential explanatory mixed methods. All participants completed a pre-course multiple choice question (MCQ) examination followed by a separate, post-course MCQ examination with a similar blueprint. A survey was also conducted to assess cognitive fatigue, perceived benefit, and potential for change in EMR practice. Finally, a delayed MCQ examination was administered 10-14 weeks later to assess knowledge retention and qualitative data were sequentially collected from 3 candidates via semi-structured interviews.

The mean pre-course score was 47.8% (SD 12.4%). The mean post-course score was 75% (9.9%) and the mean delayed score was 70.8% (13.6%), both significantly higher than the mean pre-course score (P < .001; Cohen’s d = 1.86 and P < .001; Cohen’s d = 1.47, respectively). There was no significant difference between the mean post- and delayed-course test scores (P = .2). Three themes emerged from the interviews: (1) a need for EMR training, (2) improved knowledge evaluating polyps, and (3) changed or refined EMR technique after the course.

This study demonstrates significant knowledge acquisition and retention of cognitive skills and suggests a change in practice following a 1-day focused didactic and simulation-based EMR course.

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