Walter B Kucera, MD1, Matthew Nealeigh, DO1, Brian J Dunkin, MD2, E Matthew Ritter, MD1, Aimee K Gardner, PhD3. 1Uniformed Services University/Walter Reed National Military Medical Center, 2Houston Methodist Hosptial, 3Baylor College of Medicine
INTRODUCTION: The SAGES flexible endoscopy course for minimally-invasive surgery (MIS) fellows has been shown to improve confidence and skills in performing GI endoscopy. This study evaluated the long-term retention of these confidence levels and investigated how fellows have changed practices within their fellowships as a result of the course.
METHODS: Participating MIS fellows completed surveys six months after the course. Respondents rated their confidence to independently perform sixteen endoscopic procedures (1=not at all; 5=very). While the pre- and post-course surveys identified anticipated endoscopy uses and barriers to use, the 6-month follow-up survey evaluated actual usage and barriers to use in each fellow’s practice. Respondents also noted participation in additional skills courses and status of Fundamentals of Endoscopic Surgery (FES) certification. Comparison of responses from the immediate post-course survey to the 6-month follow-up survey were examined. McNemar and paired t-tests were used for analyses.
RESULTS: Twenty-three of 57 (40%) course participants returned the 6-month survey. 26% had passed the FES skills examination and 17% had attended another flexible endoscopy course. No major barriers to endoscopy use were identified. In fact, fellows reported less competition with GI providers as a barrier to practice compared to their original post-course expectations (50% versus 86%, p<0.01). In addition, confidence was maintained in performing the majority of the 16 endoscopic procedures, although fellows reported significant decreases in confidence in independently performing snare polypectomy (-26%; p<0.05), control of variceal bleeding (-39%; p<0.05), colonic stenting (-48%; p<0.01), BARRX (-40%; p<0.05), and TIF (-31%; p<0.05). Fewer fellows used the GI suite to manage surgical problems than was anticipated post course (26% versus 74%, p<0.01). Fellows without FES certification reported loss in confidence to independently perform BARRX (-54%; p<0.05) and colonic stenting (-63%; p<0.01), and also a 58% decrease in the use of GI suite to manage surgical problems (p<0.05) Fellows who passed FES noted no significant loss of independence, changes in use, or barriers to use. 18% of fellows made additional partnerships with industry after the course. 41% stated flexible endoscopy has influenced their post-fellowship job choice. 100% would recommend the course to other fellows.
CONCLUSIONS: The SAGES flexible endoscopy course for MIS fellows results in long-term practice changes with participating fellows maintaining confidence to perform the majority of taught endoscopic procedures six months later, and over 40% reporting that flexible endoscopy influenced their career choice. Additionally, fellows experienced no major barriers to implementing endoscopy into practice.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86596
Program Number: P315
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster