It is uncertain what the learning curve is in pediatric oesophagogastroduodenoscopy (OGD). Researchers conducted learning curve studies using 95 percent D2 (second portion of the duodenum) intubation rates as a measure of technical proficiency to determine when trainees attain competency in pediatric OGD. Competency-related factors were also assessed. Between 2014 and 2018, data from juvenile OGD operations were prospectively put into the UK endoscopy training e-portfolio. To estimate the procedure numbers necessary to obtain a 95 percent D2 intubation rate, moving average and learning curve cumulative summation studies were used. A multivariable binary logistic regression method was used to examine the factors related to D2 intubation. There were 8929 operations done by 61 trainees in all. These 61 trainees have completed an average of 124.6 operations. After 79 operations, 95 percent D2 intubation was obtained using moving average analysis. According to a learning curve cumulative summation study, after 100 operations, 81.6 percent of trainees were competent. Lifetime operation count, greater trainee seniority, patient age, outpatient status, and attendance at a national Basic Skills OGD course were all multivariable variables related to unaided procedure completion.

According to this study, 79 procedures in pediatric OGD are required on average to achieve the competency outcome of 95 percent D2 intubation rates. By the end of 100 procedures, 81.6 percent of the sample had achieved 95% D2 intubation. The UK and worldwide training programs’ minimum procedural count of 100 can be used in conjunction with current objective evaluation methods to ensure proficiency within a training cohort.

Reference: https://journals.lww.com/jpgn/Fulltext/2020/03000/Learning_Curve_Analyses_for_Achieving_Satisfactory.14.aspx

 

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