A classification of the verbal methods currently used to teach endoscopy

BMC Medical Education

Michael Moser²  Michelle Prytula¹  Deng Mapiour² 

[1] Department of Educational Administration, College of Education, University of Saskatchewan, Saskatoon, Saskatchewan S7N 0W8, Canada;Department of Surgery, University of Saskatchewan, 103 Hospital Drive, Saskatoon, Saskatchewan S7N 0W8, Canada

关键词: Verbal teaching;    Skills;    Colonoscopy;    Gastroscopy;    Endoscopy;   

Others  :  1092048
DOI  :  10.1186/1472-6920-14-163

 received in 2014-04-03, accepted in 2014-08-01,  发布年份 2014

【 摘 要 】

Background

As endoscopy does not lend itself well to assisting or exposure by the teacher, most of the teaching is, by necessity, done verbally.

Methods

The verbal teaching occurring during 19 colonoscopies and 14 gastroscopies was recorded by dictaphone and later transcribed. The resultant 53-page transcript was then analyzed using the Grounded Theory method. Teaching was compared between learners with less than one month versus more than one month of training and between teaching of colonoscopy versus gastroscopy.

Results

The process of iterative review and repeated testing yielded 6 types of verbal teaching: demonstration by the teacher, motor instructions, broad tips/tricks/pointers, verbal feedback, questioning, and non-procedural information. Inter-rater agreement was excellent (Fleiss’s kappa = 0.76) between resident (DM), the non-medical educator (MP), and the medical teacher (MM). Overall, there was less non-procedural teaching (6.7% vs 23.7%, p = 0.01) and a trend towards more teaching moments per case (13.2 vs 7.9, p = 0.07) in the first month of the rotation compared to the later months. A greater proportion of the teaching for colonoscopy involved demonstration (13.7% vs. 2.7%, p = 0.040) and tips/tricks/pointers (26.6% vs. 12.4%, p = 0.012) compared to gastroscopy.

Conclusions

We describe a means of categorizing verbal teaching in endoscopy that is simple and shows strong inter-rater agreement that will serve as a starting point for further studies aiming to improve how endoscopy is taught.

【 授权许可】

   
2014 Mapiour et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Roberts NK, Williams GR, Kim MJ, Dunnington GL: The briefing, intraoperative teaching, debriefing model for teaching in the operating room. J Am Coll Surg 2009, 208:299-303.
• [2]Daetwiler S, Guller U, Schob O, Adamina M: Early introduction of laparoscopic sigmoid colectomy during residency. Br J Surg 2007, 94:634-641.
• [3]Maeda T, Tan KY, Konishi F, Tsujinaka S, Mizokami K, Sasaki J, Kawamura YJ: Trainee surgeons do not cause more conversions in laparoscopic colorectal surgery if they are well supervised. World J Surg 2009, 33:2439-2443.
• [4]Sarker SK, Vincent C, Darzi AW: Assessing the teaching of technical skills. Am J Surg 2005, 189:416-418.
• [5]Hauge LS, Wanzek JA, Godellas C: The reliability of an instrument for identifying and quantifying surgeons’ teaching in the operating room. Am J Surg 2001, 181:333-337.
• [6]Sedlack RE, Shami VM, Adler DG, Coyle WJ, DeGregorio B, Dua KS, DiMaio CJ, Lee LS, McHenry L, Pair SA, Rajan E, Faulx AL: Colonoscopy core curriculum. Gastrointest Endosc 2012, 76(3):482-490.
• [7]Thuraisingam AI, Macdonald J, Shaw IS: Insights into endoscopy training: a qualitative study of learning experience. Med Teacher 2006, 28(5):453-459.
• [8]Wells CW, Inglis S, Barton R: Trainees in gastroenterology views on teaching in clinical gastroenterology and endoscopy. Med Teacher 2009, 31:138-144.
• [9]Bittner JG, Marks JM, Dunkin BJ, Richards WO, Onders RP, Mellinger JD: Resident training in flexible gastrointestinal endoscopy: A review of current issues and options. J Surg Educ 2007, 64(6):399-409.
• [10]Park J, MacRae H, Messelman LJ, Rossos P, Hamstra SJ, Wolman S, Reznick RK: Randomized controlled trial of virtual reality simulator training: transfer to live patients. Am J Surg 2007, 194(2):205-211.
• [11]Mahmood T, Darzi A: The learning curve for a colonoscopy simulator in the absence of any feedback: no feedback, no learning. Surg Endosc 2004, 18(8):1224-1230.
• [12]Simpson EJ: The Classification of Educational Objectives in the Psychomotor Domain. Washington, DC: Gryphon House; 1972.
• [13]Harrow AJ: A Taxonomy of the Psychomotor Domain. New York: David McKay; 1972:14-31.
• [14]Singer RN: The Psychomotor Domain: Movement Behaviours. Philadelphia: Lea & Febiger; 1972:385-414.
• [15]Committee on Trauma: ATLS ® Faculty Manual. 8th edition. Chicago: American College of Surgeons; 2011.
• [16]Blom EM, Verdaasdonk EGG, Stassen LPS, Stassen HG, Wiernga PA, Dankelman J: Analysis of verbal communication during teaching in the operating room and the potentials for surgical training. Surg Endosc 2007, 21:1560-1566.
• [17]Glaser BG, Strauss A: The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago, IL: Aldine Publishing Co; 1967.
• [18]Roberts NK, Brenner MJ, Williams RG, Kim MJ, Dunnington GL: Capturing the teachable moment: A grounded theory study of verbal teaching interactions in the operating room. Surgery 2012, 151:643-650.
• [19]Hsu K, Man FY, Gizicki R, Feldman L, Fried G: Experienced surgeons can do more than one thing at a time: effect of distraction on performance of a simple laparoscopic and cognitive task by experienced and novice surgeons. Surg Endosc 2008, 22:196-201.
• [20]Cass OW: Training to competence in gastrointestinal endoscopy: a plea for continuous measuring of objective end points. Endoscopy 1999, 31:751-754.
• [21]Koch AD, Haringsma J, Schoon EJ: Competence measurement during colonoscopy training: Use of self-assessment of performance measures. Am J Gastroenterol 2012, 107:971-975.