title: Development and validation of a training module on the use of narrow-band imaging in differentiation of small adenomas from hyperplastic colorectal polyps.
abstract: BACKGROUND
  Experts are accurate in differentiating small adenomas from hyperplastic polyps at colonoscopy by using narrow-band imaging (NBI).
  
  
  OBJECTIVE
  To prospectively evaluate the effectiveness of an NBI training module on individuals with varying colonoscopy experience.
  
  
  METHODS
  Prospective educational evaluation study.
  
  
  METHODS
  Academic endoscopy unit.
  
  
  METHODS
  Twenty-one participants of varying colonoscopy experience (novices, trainees, and experienced gastroenterologists) and 5 experts in NBI.
  
  
  METHODS
  Participants completed a computer-based test module consisting of 30 NBI polyp images. No feedback was given. They then completed a computer-based training module on the use of NBI in the differentiation of adenomas and hyperplastic polyps. The test module was then completed a second time.
  
  
  METHODS
  Construct validity (the difference in baseline accuracy on the test module between different groups of participants) and content validity (difference in accuracy achieved on the test module before and after training) of the training module.
  
  
  RESULTS
  There was a significant difference in the baseline accuracy (P < .001) between experts (0.95; 95% confidence interval [CI], 0.92-0.97), experienced colonoscopists (0.68; 95% CI, 0.68-0.74), trainees (0.75; 95% CI, 0.67-0.82), and novices (0.62; 95% CI, 0.46-0.77). Accuracy increased significantly (P < .001) for all 3 groups after training (novices 0.84; 95% CI, 0.78-0.88, trainees 0.90; 95% CI, 0.84-0.93, and experienced colonoscopists 0.84; 95% CI, 0.76-0.89). After training, the agreement was moderate at least (κ = 0.56 for novices, κ = 0.70 for trainees, and κ = 0.54 for experienced colonoscopists).
  
  
  CONCLUSIONS
  This study did not assess the accuracy of optical diagnosis in routine clinical practice.
  
  
  CONCLUSIONS
  A short, computer-based training module can improve the diagnostic accuracy and interobserver agreement for the use of NBI to differentiate adenomas from hyperplastic polyps and could be used for the initial training in optical diagnosis.
authors.affiliation: Wolfson Unit for Endoscopy, St Mark’s Hospital, Harrow, Middlesex, United Kingdom.
authors.forename: Ana
authors.initials: A
authors.lastname: Ignjatovic
authors.forename: Siwan
authors.initials: S
authors.lastname: Thomas-Gibson
authors.forename: James E
authors.initials: JE
authors.lastname: East
authors.forename: Adam
authors.initials: A
authors.lastname: Haycock
authors.forename: Paul
authors.initials: P
authors.lastname: Bassett
authors.forename: Pradeep
authors.initials: P
authors.lastname: Bhandari
authors.forename: Ripple
authors.initials: R
authors.lastname: Man
authors.forename: Noriko
authors.initials: N
authors.lastname: Suzuki
authors.forename: Brian P
authors.initials: BP
authors.lastname: Saunders
mesh_terms: D000236:Adenoma / Q000473:pathology*; D002983:Clinical Competence; D003110:Colonic Neoplasms / Q000473:pathology*; D003111:Colonic Polyps / Q000473:pathology*; D003113:Colonoscopy / Q000379:methods; D003194:Computer-Assisted Instruction / Q000379:methods*; D003937:Diagnosis, Differential; D004503:Education, Medical, Graduate / Q000379:methods*; D005762:Gastroenterology / Q000193:education*; D006801:Humans; D007089:Image Enhancement; D008027:Light; D015588:Observer Variation; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results