Supporting self-regulated-learning in colonoscopy training-A comparison cohort trial

Claudia Jaensch; Rune Dall Jensen; Ryan Brydges; Charlotte Paltved; Anders Husted Madsen

doi:10.1016/j.heliyon.2024.e28133

Supporting self-regulated-learning in colonoscopy training-A comparison cohort trial

Heliyon. 2024 Mar 16;10(7):e28133. doi: 10.1016/j.heliyon.2024.e28133. eCollection 2024 Apr 15.

Authors

Claudia Jaensch¹, Rune Dall Jensen², Ryan Brydges³, Charlotte Paltved⁴, Anders Husted Madsen⁵

Affiliations

¹ Surgical Research Department, Denmark and NIDO | Centre for Research and Education, Gødstrup Hospital, Denmark.
² Department of Clinical Medicine, Aarhus University, Aarhus Denmark and Corporate HR MidtSim, Central Denmark Region, Aarhus, Denmark.
³ Simulation Program, Unity Health Toronto, and Department of Medicine, University of Toronto, Toronto, Canada.
⁴ Corporate HR MidtSim, Central Denmark Region, Aarhus, Denmark.
⁵ Surgical Research Department, Gødstrup Hospital, Denmark.

Abstract

Aim: This study aimed to demonstrate that using a self-regulated learning (SRL) approach can improve colonoscopy performance skills.

Background: Colonoscopy is the gold standard for detecting colorectal cancer and removing its precursors: polyps. Acquiring proficiency in colonoscopy is challenging, requiring completion of several hundred procedures. SRL seems to be beneficial to help trainees acquire competencies in regulating their future learning processes and enhance the outcomes of current learning situations. SRL is a learner-centred approach that refers to a trainee's ability to understand and control their learning environment, including cognitions, motivations and emotions. The key abilities include self- and situational awareness, task analysis, and strategic planning. This study is the first to use an SRL approach for workplace-based colonoscopy training.

Methods: In this comparison cohort trial, participants used two SRL supports: a self-review of videotaped performance, and an online learning platform with procedural and conceptual knowledge about colonoscopy. In the control cohort, participants performed patient-based colonoscopy as usual in their departments. Improvement was monitored via three video-based ratings (study start, end of the study period, and follow-up) using the Gastrointestinal Endoscopy Competency Assessment Tool (GiECAT). Outcomes were analysed using two-way analysis of variance with repeated measurements.

Results: This study recruited 21 participants (12, intervention cohort; nine, control cohort); 58 videos were recorded. The intraclass correlation coefficient was 0.88 (95% CI 0.61-0.98; p < 0.001). The global rating scale (GRS) and checklist (CL) in GiECAT were analysed separately. No statistically significant main effects of cohort (GRS: F(1,16) = 2.84, p = 0.11; CL: F(1,16) = 1.06, p = 0.32), test (GRS: F(2,32) = 2.56, p = 0.09; CL: F(2,32) = 0.76, p = 0.48), or interactions between cohort and test were observed (GRS: F(2,32) = 1.16, p = 0.33; CL: F(2,32) = 1.01, p = 0.37).

Conclusions: SRL in patient-based colonoscopy is feasible; however, no clear effect on performance scores was observed.

Keywords: Colonoscopy; Colonoscopy training; Self-regulated learning; Video-based rating.