Successful Training in Gastrointestinal Endoscopy - Группа авторов

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extensive experience in training and performing these procedures to provide their recommendations where data are lacking. The material presented will identify important questions about training that warrant future investigation. Over 130 accompanying edited and annotated video clips of both actual procedures and ex‐vivo animal model simulations highlight key teaching points for instructors to emphasize. The final section looks to the future of training and retraining in gastrointestinal endoscopy. Key logistical hurdles to this process are examined and the importance of keeping track of outcomes, the ultimate indicator of successful training, is emphasized. Though the focus of this textbook remains on how to learn and how to teach each technique, because doing so requires delineation and illustration of all skill sets to master, the textbook chapters and particularly the video clips unavoidably serve as learning tools for the proper performance of endoscopic techniques in addition to an authoritative primer on training.

      This new edition includes updated versions of 34 chapters from the 2011 edition and 5 new chapters on the following topics:

       Training the endoscopic teacher

       International opportunities for endoscopy training

       Online resources for endoscopic training

       Training in upper GI motility procedures

       Training in anorectal endoscopy procedures

      Text, figures, and annotated videos are also available online in the accompanying website.

      Throughout my education and career, the best teachers I have known have exuded a passion both for teaching and for lifelong learning themselves. The driving force behind this book now, as initially in 2011, was my desire to gather the collective theory and wisdom about learning endoscopy, along with training data, references to key educational resources, and insights on teaching innovation in one volume. Training in endoscopy has remained an exciting field, keeping pace with evolution in clinical practice and closely tied to efforts to deliver optimal endoscopic care to patients. This second edition of Successful Training in Endoscopy is coming together as the endoscopy community worldwide is coming together to do its part in coping with the COVID‐19 pandemic. Trainees have diligently and bravely joined on the front lines, and in many cases have had to divert time away from their usual training. Online learning activity has accelerated dramatically. At the time of publication, it is unclear how much of this change will outlast the current crisis, and what will be the extent and pace of the education transformation that appears to be taking place right now. In this context, I hope that this book will continue to serve as a guide and valuable resource for the years to come.

       Jonathan Cohen, MD, FASGE

      Acknowledgments

      I wish to thank the many authors who contributed text and video for this volume for their great efforts. I appreciate their willingness in many cases to address less explored aspects within their areas of expertise to focus on the trainee and teaching methods. Beyond that, I want to extend my gratitude to the individuals who have been my teachers throughout my life. We seldom look back far enough to acknowledge the contributions of those who first encouraged, cajoled, and stimulated our desire to learn, and in turn to teach, following their lead. I take the opportunity to recall Mrs. Smith, Mr. Kelly, and Mr. Clark, and many others.

      Despite all the advances in tools and methods of training detailed in this book, the importance of having wonderful mentors remains paramount to successful training in endoscopy. I have been particularly fortunate in this regard to have had not just one but many who have inspired me with their zest for teaching, expertise, and wisdom, and have blessed me as well with their friendship. Thanks to Sanjiv, Stuart, Dean, Fred, Greg, Paul, Norm, and Gabe. Along with my colleagues around the world, many of whom have kindly contributed to this book, they have given me a strong appreciation for the importance of training and of ongoing learning in this ever‐changing and exciting field.

      Especially thanks to my family, to Cori, Juliette, and Ben for their tremendous understanding, encouragement, and support. With the great upheavals of 2020, I have never been so mindful and grateful for each of you.

      Finally, this book is dedicated to ENJC, my parents, and original teachers, for their lifelong inspiration and for giving me the idea for this project. AEL(CFI)S!

      About the Companion Website

      This book is accompanied by a companion website:

       www.wiley.com/go/cohen/successfultraining2e

      The website includes Videos

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I The Evolution of Basic Principles and Practice

      Jonathan Cohen1 and David A. Greenwald2,3

      1 New York University Grossman School of Medicine, New York, NY, USA

      2 Mount Sinai Hospital, New York, NY, USA

      3 Icahn School of Medicine at Mount Sinai, New York, NY, USA

      Gastrointestinal endoscopy has grown increasingly more complex as the field has evolved over the past several decades, now requiring the practitioner to become proficient at many techniques. To perform high‐quality care, endoscopists often have had to devote time to learn new techniques as well as take care to continually maintain existing skills. As the technology and applications have progressed, so too have the methods by which individuals have learned to perform these procedures. In this chapter, we will trace the evolution in training from the self‐taught pioneers of the early days to the advent of formal proctored tutelage that remains the mainstay of training in this field. The chapter will also relate the emergence of numerous innovative learning tools that have already served to further transform training in gastrointestinal endoscopy. In particular, we will describe the development of simulator‐based instruction from the creation of realistic models to their validation and growing importance in endoscopic training. Lastly, we will address a number of novel principles of education in endoscopy that have paralleled the growing availability of these new teaching tools.

      Self‐training for gastrointestinal procedures was the mode by which many of the early endoscopists progressed, largely because devices and equipment became available for which there was no “expert” instruction. In general, this method is not appropriate any longer for training in standard procedures (i.e., colonoscopy, upper endoscopy) where sufficient proctoring is readily available. However, as newer techniques are introduced (i.e., endoscopic suturing, endoscopic mucosal resection (EMR), endoscopic sub‐mucosal dissection (ESD), stent placement, transluminal surgery), the question of how to satisfactorily teach these new skills becomes relevant [1]. In fact, “short courses” have been developed to review the cognitive and technical aspects associated with such procedures. American Society for Gastrointestinal Endoscopy (ASGE) guidelines concerning such “short courses” exist, and suggest them as a possible way for experienced endoscopists to acquire new skills, but reject such methods for initial training for “standard” endoscopic techniques such as colonoscopy, upper endoscopy, endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic ultrasound (EUS) [2].

      The need to impart the wisdom

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