Each site must meet logistical requirements as outlined in the SEE Colonoscopy Skills Improvement logistic requirements documents.

Transcription

1 Requirements for CAG-SEE Training Centre Certification: Each site must meet logistical requirements as outlined in the SEE Colonoscopy Skills Improvement logistic requirements documents. o To maintain status as a CAG certified SEE centre, each site must continue to meet all requirements on an ongoing basis. o SEE faculty will monitor the status of each site. Failure to maintain status will result in a probationary status and/or loss of CAG SEE certification. All certified centres must use standardized SEE course content and the CAG course administration website to advertise courses and faculty. All certified centres must partake in C-GRS. Courses in the CAG SEE program at this time include: o Train-the-Endoscopy-Trainer (TET). This course stresses improvement of endoscopy teaching skills over technical skills improvement, although there will be some skills improvement in these courses. o Colonoscopy Skills Improvement (CSI). This course concentrates on improvement of the course delegate s technical skill set. To obtain level-1 CAG SEE certification, the site must have at least 2 fully certified local CAG SEE faculty members. To achieve level-2 certification, the site must have one fully certified CAG SEE faculty member or two members in training. o A level-1 site will be expected to be able to provide TET and CSI courses at their centre. o A level-2 site will be expected to be able to provide CSI courses. V3June 2015 Page 1 of 9

2 Each site must conduct a minimum number of three courses per year. This will include CSI and TET courses for level-1 sites and CSI courses for level-2 sites. Each site will have an identified local CAG SEE certified training lead responsible for local administration and organization of courses. o The lead will also represent the site at national CAG-SEE program meetings as well as SEE -related conference calls/webinars. Each site must have at least one dedicated endoscopy room with full time access to an imager to guarantee adequate experience for trainers. o Most individuals require several months of continuous exposure to an imager to develop the conscious competence needed to be an effective trainer. o Simply bringing an imager in, for courses only, will not meet site certification requirements. Each level 1 site should have at least one local CAG- SEE certified faculty member serve as TET course faculty at least once per year. This may be a local course or off-site as external faculty. All CAG- SEE certified faculty members must commit to a minimum of three CSI and/or TET courses per year. At least once per year, the faculty member should act as external visiting faculty for a certified course. Peer evaluation of CAG-SEE certified faculty on training skills and knowledge shall be performed annually by other certified faculty members using the Direct Observation of Training Skills (DOTS) document. o This will allow CAG- SEE faculty-in-training to track their progress to certification. o Certified CAG -SEE faculty will have an annual synopsis of his/her training evaluations including any feedback from trainees in course evaluations. This will be the responsibility of the CAG- SEE leads to produce with the help of the CAG- SEE office. V3June 2015 Page 2 of 9

3 Requirements for CAG-SEE Faculty Certification: As a guideline, most new potential faculty will need a minimum of five SEE courses (three CSI courses and two TET courses) to be able to independently run CAG- SEE Colonoscopy Skills Improvement courses. Additional experience and mentorship is required to be able to function as faculty capable of delivering TET courses. Assessments will be conducted by the SEE Co-leads to determine if an individual requires additional mentorship before full certification. Courses in the CAG -SEE program at this time include: o Train-the-Endoscopy-Trainer (TET). This course stresses improvement of endoscopy teaching skills over technical skills improvement, although there will be some skills improvement in these courses. o Colonoscopy Skills Improvement (CSI). This course concentrates on improvement of the course delegate s technical skill set. For certification, CAG- SEE faculty must demonstrate ability to: Explain concepts of conscious competence and the need for conscious competence of colonoscopy to be an effective colonoscopy trainer. Understand and be able to describe the elements of the competency framework for effective teaching including preparation (educational contract), performance enhancing training and wrap up (feedback). Exhibit the ability to deliver effective feedback. Demonstrate recommended scope handling technique and explain rationale for these methods including improved efficiency and ergonomics. Explain torque steering and potential advantages for tip control compared to wheel steering. Teach basic elements of loop reduction. V3June 2015 Page 3 of 9

4 Communicate advantages and rational for position change on insertion and withdrawal. Demonstrate the ability to recognize common problems occurring outside the patient including inappropriate physical set up and issues with nontechnical skills such as communication, judgment and patient safety. Be able to recognize basic loops using the Olympus Scope guide and be able to teach a logical approach to loop recognition and handling. Be familiar with various common problems that occur during colonoscopy. This includes demonstrating approaches to common vignettes that arise at sigmoid colon, splenic flexure, hepatic flexure and cecum. Reveal an ability to teach colleagues in a nonjudgmental manner. Be willing to undergo an annual evaluation of teaching skills with (DOTS) document. V3June 2015 Page 4 of 9

5 Appendix 1: CAG-SEE Colonoscopy Skills Improvement Course Logistics And Physical Requirements: One-day Version: Hands on training in Department. 1) One endoscopy suite with AV link to seminar room. 2) Olympus scope guide in endoscopy suite to be used during all cases. 3) Need AV/IT functionality to have endoscopic view, room view and imager view transmitted simultaneously. Either on single split screen or on three separate screens. (Can use single screen and flip between images, but this is less optimal and educational for delegates). 4) Need audio link from delegate and endoscopist in endoscopy room to be heard in seminar room. Not essential for audio link between seminar room and endoscopy suite if not possible. 5) Two colon cases per delegate (three delegates) with spare case(s) in case of DNA/bad prep/obstructing pathology etc. 6) Need spare local faculty to finish colons and any spare cases. Also makes sure any report writing/patient liaison is completed. 7) Two flip charts and pens in seminar room. 8) Table in seminar room. 9) Scope in seminar room for hands-on demonstrations (can be a gastroscope). 10) Chairs for delegates, faculty and observers in half circle. 11) AV facility data projector and PC 12) Coffee and lunch for course participants provided during the day. V3June 2015 Page 5 of 9

6 In general, each delegate gets 30 minutes with a case. The clock starts to run when the scope is introduced into the rectum. At 30 minutes, or sooner if the faculty feel no further learning is to be gained, the delegate and faculty member hand over the case to the bull pen for completion and return to the seminar room for the feedback and discussion session. Regardless, the case ends at 30 minutes. This is very important to keep the day flowing smoothly. I suggest meeting at 0800 to get background on delegates, to set learning agendas for delegates and faculty and to provide initial teaching before starting live cases. This probably should include demonstration of correct posture, room set up and how to hold the scope. We suggest that patients who have had a poor or difficult colonoscopy experience in the past, patients who are expected to need additional colonoscopies in the future, and any patient who has had prior colon resection not be used as teaching cases for these courses. V3June 2015 Page 6 of 9

7 Appendix 2: CAG SEE Train-the-Endoscopy-Trainer Course: Logistics And Physical Requirements. Day One: We suggest that SEE faculty should meet in the seminar room for one to two hours before course begins. This allows faculty members to get background on delegates, to set learning agendas for delegates and faculty, to determine that logistical requirements have been met, and to populate flip charts before starting the course. First day (4 hours) training will occur in the seminar room. This can be an afternoon or evening session. In our experience, the afternoon seems to be better appreciated by faculty and delegates, as this leads to a less compressed and intense experience for all. Having the evening gives delegates time to reflect on some of the new techniques which have been taught and which will be used the following day. Up to 6 delegates can be trained in these courses. Logistic Requirements: 1) Two flip charts and pens in seminar room. 2) Table in seminar room. 3) Scope in seminar room for hands-on demonstrations (may be a gastroscope). 4) Chairs for delegates, faculty and observers in half circle. 5) AV facility data projector and PC An evening get together of faculty and delegates is optional. This may serve to break the ice and reduce the stress of delegates before their training the next day. V3June 2015 Page 7 of 9

8 Day Two: We recommend that all faculty and delegates arrive by 0800 and meet over breakfast and coffee. The faculty will provide an introduction and overview of the day. Each delegate will be asked for his or her learning objectives for the day. We recommend 6 colonoscopy cases be booked, generally an hour each. This gives each delegate an opportunity to train at least once during the course. In general, local residents perform the endoscopy and are trained by course delegates under the supervision of a faculty member. Delegates may take an optional opportunity for skills improvement if they wish by performing colonoscopy while supervised by a fellow delegate. In general, each delegate will have a 30-minute training session during the case. The clock starts to run when the scope is introduced into the rectum. At 30 minutes, or sooner if the faculty feel no further learning is to be gained, the delegate and faculty member hand over the case to the bull pen for completion and return to the seminar room for the feedback and discussion session. Regardless, the case ends at 30 minutes. This is very important to keep the day flowing smoothly. An extra case may be booked in case of no show, poor prep, or pathology. A local faculty member will need to be designated in the bullpen to take over and finish each case. This responsibility includes case dictation and arranging any follow up care. We suggest that patients who have had a poor or difficult colonoscopy experience in the past, patients who are expected to need additional colonoscopies in the future, and any patient who has had prior colon resection not be used as teaching cases for these courses. V3June 2015 Page 8 of 9

9 Logistic requirements: 1) One endoscopy room with AV link to seminar room. 2) Need AV/IT functionality to have endoscopic view, room view and imager view transmitted simultaneously. Either on single split screen or on three separate screens. (Can use single screen and flip between images, but this is less optimal and educational for delegates). 3) Need audio link from delegate and endoscopist in endoscopy room to be heard in seminar room. Not essential for audio link between seminar room and endoscopy suite if not possible. 4) Two colon cases per delegate with spare case(s) in case of DNA/bad prep/obstructing pathology etc. 5) Need spare local faculty to finish colons and any spare cases. Also makes sure any report writing/patient liaison is completed. 6) Two flip charts and pens in seminar room. 7) Table in seminar room. 8) Scope in seminar room for hands-on demonstrations (may be a gastroscope). 9) Chairs for delegates, faculty and observers in half circle. 10) AV facility data projector and PC 11) Coffee and lunch for course participants provided during the day. V3June 2015 Page 9 of 9