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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

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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.

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Acknowledgements

The authors would like to thank Agnès Gronfier, Lesley Daloz and Gaelle Lechner-Giovannoni for the assistance in collecting data for the present paper and Isabelle Petty for medical English proofreading.

Funding

The study was funded by a grant from the French National Research Association (Grant no. ANR-15-IDFN-0011) to the IHU.

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Authors and Affiliations

  1. Endoscopia Digestiva Chirurgica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

    Pietro Mascagni

  2. Institute of Image-Guided Surgery, Institut Hospitalo-Universitaire (IHU), Strasbourg, France

    Pietro Mascagni, Pietro Riva, Ludovica Guerriero, Eran Shlomovitz, Jacques Marescaux, Lee Swanström & Silvana Perretta

  3. Department of General Surgery, Humanitas Research Hospital IRCCS, Milano, Italy

    Pietro Riva

  4. Department of Surgery and Medical Imaging, University Health Network, Toronto, Canada

    Eran Shlomovitz

  5. Department of General, Digestive, and Endocrine Surgery, University Hospital of Strasbourg, Strasbourg, France

    Silvana Perretta

  6. IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France

    Bernard Dallemagne, Jacques Marescaux & Silvana Perretta

Authors
  1. Pietro Mascagni
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  2. Pietro Riva
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  3. Ludovica Guerriero
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  4. Eran Shlomovitz
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  5. Bernard Dallemagne
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  6. Jacques Marescaux
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  7. Lee Swanström
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  8. Silvana Perretta
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Corresponding author

Correspondence to Silvana Perretta.

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Disclosures

Jacques Marescaux is the President of the IRCAD Institute, which is partly funded by Karl Storz and Medtronic. Pietro Mascagni, Pietro Riva, Ludovica Guerriero, Eran Shlomovitz, Bernard Dallemagne, Lee Swanström and Silvana Perretta have no conflicts of interest or financial ties to disclose.

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Mascagni, P., Riva, P., Guerriero, L. et al. 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. Surg Endosc 35, 2473–2479 (2021). https://doi.org/10.1007/s00464-020-07657-7

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  • DOI: https://doi.org/10.1007/s00464-020-07657-7

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