A205 A PROSPECTIVE ASSESSMENT OF INSERTION VERSUS WITHDRAWAL AS A COMPONENT OF A COLONOSCOPY TECHNICAL SKILLS ACQUISITION CIRRICULUM
Bibliographic record
Abstract
Colonoscopy technical skills curricula should include methods that reduce trainee anxiety and optimize success. One variable factor in training programs is whether trainees begin learning with colonoscope withdrawal that focuses on scope tip control and luminal view, or insertion that requires additional skills in navigation. The aim of this project was to determine whether colonoscopy training focussing on colonoscope withdrawal leads to lower stress levels, cognitive workload, and increased perceived helpfulness in skills acquisition. Participants were internal medicine trainees with no prior endoscopy experience. After initial simulation lab teaching with models, trainees were randomized to start with insertion or withdrawal phase of a colonoscopy, with one of two gastroenterologists as trainers. Salivary cortisol levels and State-Trait Anxiety Inventory (STAI) surveys from participants were compared at baseline and following each procedure to assess stress level. NASA Task Load Index (TLX) survey was used to assess cognitive workload. A visual analogue scale was used to assess perceived helpfulness of the training program on specific colonoscopy technical skills. Paired t-tests were used to compare the results between withdrawal and insertion, and between first and second procedure. 11 trainees were randomized. No significant differences in cortisol, STAI levels, workload, or reported helpfulness were detected between withdrawal or insertion (Table 1). Of the trainees, 70.0% reported insertion teaching to be of greater value, 20.0% reported withdrawal, and 10.0% found both equally valuable. Of the trainers, only 22.2% found insertion more valuable and 77.8% found withdrawal more valuable. Training of insertion or withdrawal colonoscopy technical skills did not result in differences in trainee stress, cognitive workload, nor perceived helpfulness in skills acquisition. Residents reported higher perceived value in learning the more complicated insertion method; whereas their trainers reported higher value in withdrawal. With neither insertion nor withdrawal identified as a superior method for teaching, gastroenterologists and residents could utilize the method they are most comfortable with. Longitudinal data collection on skill acquisition rates could possibly clarify which approach is optimal. Table 1. Changes in stress level, workload, and perceived helpfulness of procedure compared between withdrawal and insertion procedures SD: standard deviation SEAMO Clinician Scientist Award
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".