Endoscopy 2024; 56(06): 421-430
DOI: 10.1055/a-2245-6526
Original article

Effect of an online educational module incorporating real-time feedback on accuracy of polyp sizing in trainees: a randomized controlled trial

1   Division of Gastroenterology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, United States
,
Timothy Yen
1   Division of Gastroenterology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, United States
,
Camille J. Hochheimer
2   Department of Biostatistics and Informatics, Center for Innovative Design and Analysis, Colorado School of Public Health, Aurora, United States
,
Wyatt Tarter
2   Department of Biostatistics and Informatics, Center for Innovative Design and Analysis, Colorado School of Public Health, Aurora, United States
,
Tonya Kaltenbach
3   Division of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, United States
4   San Francisco Veterans Affairs Medical Center, San Francisco, United States
,
Rajesh N. Keswani
5   Division of Gastroenterology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, United States
,
Sachin Wani
1   Division of Gastroenterology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, United States
,
Swati G. Patel
1   Division of Gastroenterology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, United States
6   Department of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, United States
› Author Affiliations
Supported by: AGA Research Foundation - Academy of Educators Received December 14, 2020.
Supported by: NIH/NCATS Colorado CTSA Grant UL1 TR002535

Clinical Trial: Registration number (trial ID): NCT05846295, Trial registry: ClinicalTrials.gov (http://www.clinicaltrials.gov/), Type of Study: Multicenter Randomized Controlled Trial


Abstract

Background Although polyp size dictates surveillance intervals, endoscopists often estimate polyp size inaccurately. We hypothesized that an intervention providing didactic instruction and real-time feedback could significantly improve polyp size classification.

Methods We conducted a multicenter randomized controlled trial to evaluate the impact of different components of an online educational module on polyp sizing. Participants were randomized to control (no video, no feedback), video only, feedback only, or video + feedback. The primary outcome was accuracy of polyp size classification into clinically relevant categories (diminutive [1–5mm], small [6–9mm], large [≥10mm]). Secondary outcomes included accuracy of exact polyp size (inmm), learning curves, and directionality of inaccuracy (over- vs. underestimation).

Results 36 trainees from five training programs provided 1360 polyp size assessments. The feedback only (80.1%, P=0.01) and video + feedback (78.9%, P=0.02) groups had higher accuracy of polyp size classification compared with controls (71.6%). There was no significant difference in accuracy between the video only group (74.4%) and controls (P=0.42). Groups receiving feedback had higher accuracy of exact polyp size (inmm) and higher peak learning curves. Polyps were more likely to be overestimated than underestimated, and 29.3% of size inaccuracies impacted recommended surveillance intervals.

Conclusions Our online educational module significantly improved polyp size classification. Real-time feedback appeared to be a critical component in improving accuracy. This scalable and no-cost educational module could significantly decrease under- and overutilization of colonoscopy, improving patient outcomes while increasing colonoscopy access.

Supplementary Material



Publication History

Received: 28 August 2023

Accepted after revision: 15 January 2024

Accepted Manuscript online:
15 January 2024

Article published online:
22 February 2024

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