Randomized controlled study of the prediction of diminutive/small colorectal polyp histology using didactic versus computer‐based self‐learning module in gastroenterology trainees

• Published in: Digestive endoscopy Vol. 31; no. 5; pp. 535 - 543
• Main Authors: Smith, Samuel C. L., Saltzman, John, Shivaji, Uday N., Lethebe, Brendan C., Cannatelli, Rosanna, Ghosh, Subrata, Iacucci, Marietta, Baker, G, Bannaga, A, Fowler, H, Geh, D, Gupta, T, Harvey, PR, Khan, S, Kumar, A, Lim, P, McCulloch, A, O'Rourke, J, Polewiczowska, B, Qurashi, M, Tahir, F, Widlak, MM
• Format: Journal Article
• Language: English
• Published: Australia 01.09.2019
• Subjects: Clinical Competence; colonic polyp; Colonic Polyps - diagnosis; Colonoscopy - education; Computer-Assisted Instruction; Education, Medical, Graduate; Educational Measurement; Gastroenterology - education; Humans; Learning Curve; optical enhancement; polyp characterization; training module; virtual chromoendoscopy; training module; optical enhancement; colonic polyp; virtual chromoendoscopy; polyp characterization
• ISSN: 0915-5635; 1443-1661
• DOI: 10.1111/den.13389

Background and Aim The aim of this randomized trial was to evaluate the performance of self‐training versus didactic training in order to increase the diagnostic accuracy of diminutive/small colonic polyp histological prediction by trainees. Methods Sixteen trainees reviewed 78 videos (48 iSCAN‐OE and 30 NBI) of diminutive/small polyps in a pretraining assessment. Trainees were randomized to receive computer‐based self‐learning (n = 8) or didactic training (n = 8) using identical teaching materials and videos. The same 78 videos, in a different randomized order, were assessed. The NICE (NBI International Colorectal Endoscopic) and SIMPLE (Simplified Identification Method for Polyp Labeling during Endoscopy) classification systems were used to classify diminutive/small polyps. Results A higher proportion of high‐confidence predictions of polyps was made by the self‐training group versus the didactic group using both the SIMPLE classification (77.1% [95% CI 73.4–80.3] vs 69.9% [95% CI 66.1–73.5%] [P = 0.005]) and the NICE classification (77% [95% CI 73.2–80.4%] vs 69.8% [95% CI 66–73.4%] [P = 0.006]). When using NICE, sensitivity of the self‐training group compared with the didactic group was 72% versus 83% (P = 0.0005), and the accuracy was 66.1% versus 69.1%. The training improved the confidence of participants and SIMPLE was preferred over NICE. Conclusion Self‐learning for the prediction of diminutive/small polyp histology is a method of training that can achieve results similar to didactic training. Availability of adequate self‐learning teaching modules could enable widespread implementation of optical diagnosis in clinical practice.