Impact of a simulation-based induction programme in gastroscopy on trainee outcomes and learning curves

BACKGROUND Pre-clinical simulation-based training(SBT)in endoscopy has been shown to augment trainee performance in the short-term,but longer-term data are lacking.AIM To assess the impact of a two-day gastroscopy induction course combining theory and SBT(Structured PRogramme of INduction and Training–SPRINT)on trainee outcomes over a 16-mo period.METHODS This prospective case-control study compared outcomes between novice SPRINT attendees and controls matched from a United Kingdom training database.Study outcomes comprised:(1)Unassisted D2 intubation rates;(2)Procedural discomfort scores;(3)Sedation practice;(4)Time to 200 procedures;and(5)Time to certification.RESULTS Total 15 cases and 24 controls were included,with mean procedure counts of 10 and 3(P=0.739)pre-SPRINT.Post-SPRINT,no significant differences between the groups were detected in long-term D2 intubation rates(P=0.332)or discomfort scores(P=0.090).However,the cases had a significantly higher rate of unsedated procedures than controls post-SPRINT(58%vs 44%,P=0.018),which was maintained over the subsequent 200 procedures.Cases tended to perform procedures at a greater frequency than controls in the post-SPRINT period(median:16.2 vs 13.8 per mo,P=0.051),resulting in a significantly greater proportion of cases achieving gastroscopy certification by the end of follow up(75% vs 36%,P=0.017).CONCLUSION In this pilot study,attendees of the SPRINT cohort tended to perform more procedures and achieved gastroscopy certification earlier than controls.These data support the role for wider evaluation of pre-clinical induction involving SBT.