Читать книгу Practical Pediatric Gastrointestinal Endoscopy - Группа авторов - Страница 52

A relatively recent trend towards ensuring both quality of training and patient safety has prompted educators to seek complementary methods of teaching endoscopy to enhance apprenticeship approaches. In particular, magnetic endoscopic imaging has been developed to provide real‐time images that display three‐dimensional views of the colonoscope shaft configuration and its position within the abdomen during an endoscopic procedure [3]. A metaanalysis of 13 randomized studies found that use of magnetic endoscopic imaging during real‐life colonoscopy is associated with a lower risk of procedure failure, reduced patient pain scores and a shorter time to cecal intubation, compared with conventional endoscopy [4]. With regard to training, research indicates that use of an imager may enhance learners’ understanding of loop formation and loop reduction maneuvers [5].

Simulation‐based training provides a learner‐centered environment for learners to master basic techniques and even make mistakes, without risking harm to patients [6,7]. Mastery of basic skills in a low‐risk controlled environment, prior to performance on real patients, enables trainees to focus on more complex clinical skills [6]. Additionally, within the simulated setting, learners can rehearse key aspects of procedures at their own pace, training can be structured to maximize learning, and errors can be allowed to occur unhindered, with the goal of allowing trainees to learn from their mistakes [8].

However, it is important to recognize that simply providing trainees with access to simulators does not guarantee that they will be used effectively. Instead, there are clearly a number of best practices in simulation‐based education – including feedback, repetitive practice, distributed practice, mastery learning, interactivity, and range of difficulty – which must be employed by the educator to optimize learning [9–13]. Additionally, feedback must be carefully deployed at the end of the simulation with the intention of promoting successful procedural mastery [10,12]. Indeed, terminal feedback, defined as feedback given by a trainer to a trainee at the end of task completion, is more effective than both feedback given during task performance (which can lead to overreliance on feedback by the learner) and/or withholding feedback, which has been shown to handicap learning [14,15]. In short, the simulated setting allows educators to employ a number of strategies, including terminal feedback, which can be detrimental to patient safety when teaching in the clinical setting.