Colon polypectomy report card improves polypectomy competency: results of a prospective quality improvement study (with video). 2019

Anna M Duloy, and Tonya R Kaltenbach, and Mariah Wood, and Dyanna L Gregory, and Rajesh N Keswani
Department of Gastroenterology and Hepatology, University of Colorado, Aurora, Colorado, USA.

Polypectomy competency varies significantly among providers. Poor polypectomy technique may lead to interval cancer and/or adverse events. Our aim was to determine the effect of a polypectomy skills report card on subsequent polypectomy performance. We conducted a 3-phase, prospective, single-blinded study. In phase 1 ("baseline"), we graded 10 polypectomies per endoscopist using the Direct Observation of Polypectomy Skills (DOPyS) tool (scores 1-4); mean overall scores ≥3 are competent. In phase 2 ("pre-report card"), we selected 10 additional polypectomies per endoscopist. We subsequently gave endoscopists a report card with baseline scores and instructional videos demonstrating optimal polypectomy technique. In phase 3 ("post-report card"), 10 additional polypectomies per endoscopist were selected. Raters, blinded to study phase, graded 10 pre- and 10 post-report card polypectomies per endoscopist. We compared mean DOPyS scores and rate of competent polypectomy in the pre- and post-report card phases. We graded 110 pre- and 110 post-report card polypectomies performed by 11 endoscopists. The mean DOPyS score increased between the pre- and post-report card phases (2.7 ± .9 vs 3.0 ± .8, P = .01); this improvement was seen for diminutive (P < .0001) but not for small-to-large polyps. Rate of competent polypectomy significantly improved from the pre- to post-report card phase (56% vs 69%, P = .04); this improvement was seen for diminutive (57% vs 81%, P = .001) but not for small-to-large polyps (55% vs 36%, P = .2). Report cards with educational videos effectively improved polypectomy technique, primarily because of improvements in resecting diminutive polyps. The improved competency and decreased piecemeal resection may reduce the risk of polyp recurrence. Further education is needed to improve larger polyp resection.

UI MeSH Term Description Entries
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002983 Clinical Competence The capability to perform acceptably those duties directly related to patient care. Clinical Skills,Competence, Clinical,Clinical Competency,Clinical Skill,Competency, Clinical,Skill, Clinical,Skills, Clinical,Clinical Competencies,Competencies, Clinical
D003111 Colonic Polyps Discrete tissue masses that protrude into the lumen of the COLON. These POLYPS are connected to the wall of the colon either by a stalk, pedunculus, or by a broad base. Colonic Polyp,Polyp, Colonic,Polyps, Colonic
D003113 Colonoscopy Endoscopic examination, therapy or surgery of the luminal surface of the colon. Colonoscopic Surgical Procedures,Surgical Procedures, Colonoscopic,Colonoscopic Surgery,Surgery, Colonoscopic,Colonoscopic Surgeries,Colonoscopic Surgical Procedure,Colonoscopies,Procedure, Colonoscopic Surgical,Procedures, Colonoscopic Surgical,Surgeries, Colonoscopic,Surgical Procedure, Colonoscopic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000068156 Formative Feedback Information communicated to the learner that is intended to modify the learner’s thinking or behavior for the purpose of improving learning. Constructive Feedback,Feedback (Learning),Feedback, Constructive,Feedback, Formative
D000072102 Gastroenterologists Physicians who specialize in treating diseases of the DIGESTIVE SYSTEM. Hepatologists,Gastroenterologist,Hepatologist
D000236 Adenoma A benign epithelial tumor with a glandular organization. Adenoma, Basal Cell,Adenoma, Follicular,Adenoma, Microcystic,Adenoma, Monomorphic,Adenoma, Papillary,Adenoma, Trabecular,Adenomas,Adenomas, Basal Cell,Adenomas, Follicular,Adenomas, Microcystic,Adenomas, Monomorphic,Adenomas, Papillary,Adenomas, Trabecular,Basal Cell Adenoma,Basal Cell Adenomas,Follicular Adenoma,Follicular Adenomas,Microcystic Adenoma,Microcystic Adenomas,Monomorphic Adenoma,Monomorphic Adenomas,Papillary Adenoma,Papillary Adenomas,Trabecular Adenoma,Trabecular Adenomas
D001296 Audiovisual Aids Auditory and visual instructional materials. Visual Aids,Audio-Visual Aids,Aid, Audio-Visual,Aid, Audiovisual,Aid, Visual,Aids, Audio-Visual,Aids, Audiovisual,Aids, Visual,Audio Visual Aids,Audio-Visual Aid,Audiovisual Aid,Visual Aid
D015179 Colorectal Neoplasms Tumors or cancer of the COLON or the RECTUM or both. Risk factors for colorectal cancer include chronic ULCERATIVE COLITIS; FAMILIAL POLYPOSIS COLI; exposure to ASBESTOS; and irradiation of the CERVIX UTERI. Colorectal Cancer,Colorectal Carcinoma,Colorectal Tumors,Neoplasms, Colorectal,Cancer, Colorectal,Cancers, Colorectal,Carcinoma, Colorectal,Carcinomas, Colorectal,Colorectal Cancers,Colorectal Carcinomas,Colorectal Neoplasm,Colorectal Tumor,Neoplasm, Colorectal,Tumor, Colorectal,Tumors, Colorectal

Related Publications

Anna M Duloy, and Tonya R Kaltenbach, and Mariah Wood, and Dyanna L Gregory, and Rajesh N Keswani
January 1998, The Milbank quarterly,
Anna M Duloy, and Tonya R Kaltenbach, and Mariah Wood, and Dyanna L Gregory, and Rajesh N Keswani
June 2019, Gastrointestinal endoscopy,
Anna M Duloy, and Tonya R Kaltenbach, and Mariah Wood, and Dyanna L Gregory, and Rajesh N Keswani
January 2001, Pediatrics,
Anna M Duloy, and Tonya R Kaltenbach, and Mariah Wood, and Dyanna L Gregory, and Rajesh N Keswani
November 2014, World journal of gastroenterology,
Anna M Duloy, and Tonya R Kaltenbach, and Mariah Wood, and Dyanna L Gregory, and Rajesh N Keswani
June 2020, Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry,
Anna M Duloy, and Tonya R Kaltenbach, and Mariah Wood, and Dyanna L Gregory, and Rajesh N Keswani
March 1984, Deutsche medizinische Wochenschrift (1946),
Anna M Duloy, and Tonya R Kaltenbach, and Mariah Wood, and Dyanna L Gregory, and Rajesh N Keswani
January 1999, International anesthesiology clinics,
Anna M Duloy, and Tonya R Kaltenbach, and Mariah Wood, and Dyanna L Gregory, and Rajesh N Keswani
January 2024, The Journal of nursing education,
Anna M Duloy, and Tonya R Kaltenbach, and Mariah Wood, and Dyanna L Gregory, and Rajesh N Keswani
May 2022, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society,
Anna M Duloy, and Tonya R Kaltenbach, and Mariah Wood, and Dyanna L Gregory, and Rajesh N Keswani
January 2006, Journal of nursing care quality,
Copied contents to your clipboard!