A curriculum to democratize and standardize flexible endoscopy fundamental knowledge and skills: a critical review of th
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and Other Interventional Techniques
A curriculum to democratize and standardize flexible endoscopy fundamental knowledge and skills: a critical review of the first 5 years of a surgical endoscopy university diploma Pietro Mascagni1,2 · Pietro Riva2,3 · Ludovica Guerriero2 · Eran Shlomovitz2,4 · Bernard Dallemagne6 · Jacques Marescaux2,6 · Lee Swanström2 · Silvana Perretta2,5,6 Received: 3 March 2020 / Accepted: 15 May 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background As flexible endoscopy offers many advantages to patients, access to training should be aggressively encouraged. In 2014, the IRCAD-IHU-Strasbourg launched a year-long university diploma using advanced education methods to offer surgeons and gastroenterologists high-quality, personalized training in flexible endoscopy. This paper describes and critically reviews the first 5 years of the University Diploma in Surgical Endoscopy (UDSE). Methods The UDSE aims to progressively transmit theoretical knowledge, clinical judgment, and practical skills on basic and advanced flexible endoscopy. The 300-h year-long curriculum is composed of 100 h of online lectures with tests, 150 h of clinical rotations and 50 h of hands-on sessions. The hands-on training is delivered through validated mechanical simulators, virtual reality simulators, and specifically designed ex vivo and in vivo animal models. Participants’ demographics, training, and clinical experience were recorded. Trainees’ evaluations of each online lecture, hands-on training, and clinical rotations were assessed using a Likert scale from 1 (not satisfactory) to 5 (outstanding). Trainees’ skill progression was evaluated using the Global Assessment of Gastrointestinal Endoscopic Skills (GAGES) proficiency test. Finally, clinical uptake was surveyed. Results 162 (79.01% males) trainees from 38 countries enrolled and successfully completed the first 5 courses. The vast majority of the trainees were surgeons and 19.14% were gastroenterologist. Sixty-nine (42.59%) participants were residents and 97 (56.79%) had no prior experience in flexible endoscopy. The online lectures, on-site sessions, and clinical rotations were highly appreciated receiving an overall average score of 4.33/5, 4.56/5, 4.43/5, respectively. Trainees’ endoscopic skills improved significantly (16.68 vs. 20.53 GAGES scores; p = 0.016). At an average of 18.83 months following the course, 31 alumni (77.50% of repliers) started to use a flexible endoscope in their practice. Conclusions Over its 5-year evolution, the UDSE has proven to be a valid means to ease access to the fundamental knowledge, practical skills, and clinical judgment necessary to achieve proficiency in surgical endoscopy. Keywords Flexible endoscopy · Surgical endoscopy · Education · Competency-based training Flexible endoscopy is increasingly recognized as an essential component of modern medicine and digestive surgery. Likewise, the tools available for advanced surgical
endoscopy also offer an opportunity for gastroenterol
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