An endoscopic training and assessment model for argon plasma coagulation

Area of Science:

• Gastroenterology
• Medical Education
• Endoscopic Procedures

Background:

• Argon plasma coagulation (APC) is a standard treatment for gastrointestinal bleeding.
• Current practice lacks standardized metrics for assessing technical proficiency in APC.
• Need for objective tools to evaluate and improve trainee skills in APC.

Purpose of the Study:

• To evaluate the effectiveness of a Quick APC Training Test (QAPCTT) in improving performance.
• To determine if QAPCTT can serve as a tool to assess technical proficiency in APC.
• To assess the impact of a structured APC curriculum on trainee knowledge and skills.

Main Methods:

• Endoscopy trainees performed the QAPCTT using an in vivo model before and after an APC curriculum.
• The curriculum included didactic lectures and hands-on training.
• Performance was assessed by measuring task completion time, inadvertent mucosal touchdowns, and overall technical proficiency scores.

Main Results:

• Post-curriculum, 100% of fellows were comfortable with APC equipment, compared to 21% pre-test (p < 0.001).
• Technically proficient trainees using QAPCTT showed significantly reduced time for task completion (100s vs. 215s; p = 0.006).
• Proficient trainees had significantly fewer inadvertent mucosal touchdowns (5 vs. 19; p = 0.0017).

Conclusions:

• Dedicated APC training, including a structured curriculum and hands-on practice, is essential for competence.
• The QAPCTT effectively improves APC technique and identifies trainees needing further experience.
• The QAPCTT is a valuable tool for assessing and enhancing proficiency in Argon Plasma Coagulation.