The synergistic role of virtual coaching with simulation‐based mastery learning for upper endoscopy
Tiffany Nguyen‐Vu,
YungKa Chin,
Carmel Malvar,
Patricia Anne Cabral‐Prodigalidad,
Mark De Lusong,
Hasan Maulahela,
Parit Mekaroonkamol,
Andrew Ong,
Angela Djajakusuma,
Thomas Myint,
Hilda Nurmalihah,
Ravishankar Asokkumar,
Carlos Francisco,
Jesse Liu,
Rungsun Rerknimitr,
Amandeep Shergill,
Silvia Sanduleanu,
Tonya Kaltenbach,
Roy Soetikno
Affiliations
Tiffany Nguyen‐Vu
Department of Medicine University of California San Francisco USA
YungKa Chin
Department of Gastroenterology and Hepatology Singapore General Hospital Singapore Singapore
Carmel Malvar
Department of Medicine University of California San Francisco USA
Patricia Anne Cabral‐Prodigalidad
Institute of Digestive and Liver Diseases St. Luke's Medical Center Taguig City Philippines
Mark De Lusong
Department of Gastroenterology University of the Philippines Philippine General Hospital Manila Philippines
Hasan Maulahela
Division of Gastroenterology Department of Internal Medicine Faculty of Medicine University of Indonesia‐Cipto Mangunkusumo National General Hospital Jakarta Indonesia
Parit Mekaroonkamol
Department of Gastroenterology, Center of Excellence for Innovation and Endoscopy in Gastrointestinal OncologyChulalongkorn UniversityBangkok Thailand
Andrew Ong
Department of Gastroenterology and Hepatology Singapore General Hospital Singapore Singapore
Angela Djajakusuma
Department of Gastroenterology University of the Philippines Philippine General Hospital Manila Philippines
Thomas Myint
Department of Gastroenterology and Hepatology California Pacific Medical Center San Francisco USA
Hilda Nurmalihah
Division of Gastroenterology Department of Internal Medicine Faculty of Medicine University of Indonesia‐Cipto Mangunkusumo National General Hospital Jakarta Indonesia
Ravishankar Asokkumar
Department of Gastroenterology and Hepatology Singapore General Hospital Singapore Singapore
Carlos Francisco
Institute of Digestive and Liver Diseases St. Luke's Medical Center Taguig City Philippines
Jesse Liu
Department of Gastroenterology and Hepatology California Pacific Medical Center San Francisco USA
Rungsun Rerknimitr
Department of Gastroenterology, Center of Excellence for Innovation and Endoscopy in Gastrointestinal OncologyChulalongkorn UniversityBangkok Thailand
Amandeep Shergill
Department of Medicine University of California San Francisco USA
Silvia Sanduleanu
Division of Gastroenterology and Hepatology Maastricht University Medical Center Maastricht the Netherlands
Tonya Kaltenbach
Department of Medicine University of California San Francisco USA
Roy Soetikno
Department of Medicine University of California San Francisco USA
Abstract Introduction Our simulation‐based mastery learning (SBML) curriculum, delivered in person, has been shown to successfully train novices in structured esophagogastroduodenoscopy (EGD). SBML with virtual coaching (VC) has the potential to improve the effectiveness and efficiency of endoscopy training and expand access to trainees from around the world. We share our observations conducting an EGD training course using SBML with VC. Methods We conducted a 1‐week virtual SBML course for novice trainees across seven academic centers in the USA and Asia. The cognitive component was delivered using an online learning platform. For technical skills, a virtual coach supervised hands‐on training and local coaches provided assistance when needed. At the end of training, an independent rater assessed simulation‐based performance using a validated assessment tool. We assessed the clinical performance of 30 EGDs using the ASGE Assessment of Competency in Endoscopy tool. We compared the trainees’ scores to our cohort trained using in‐person SBML training using non‐inferiority t‐tests. Results We enrolled 21 novice trainees (mean age: 30.8 ± 3.6 years; female: 52%). For tip deflection, the trainees reached the minimum passing standard after 31 ± 29 runs and mastery after 52 ± 37 runs. For structured EGD, the average score for the overall exam was 4.6 ± 0.6, similar to the in‐person cohort (4.7 ± 0.5, p = 0.49). The knowledge‐based assessment was also comparable (virtual coaching: 81.9 ± 0.1; direct coaching: 78.3 ± 0.1; p = 0.385). Over time, our novice trainees reached clinical competence at a similar rate to our historical in‐person control. Conclusions VC appears feasible and effective for training novice gastroenterology trainees. VC allowed us to scale our SBML course, expand access to experts, and administer SBML simultaneously across different sites at the highest standards.
