title: Effect of dedicated and supervised training on achieving competence in EUS-FNA of solid pancreatic lesions.
abstract: OBJECTIVE
  The diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been suggested as a benchmark of quality performance in EUS. However, there is paucity of data on the training requirement for competency in EUS-FNA of the pancreas. KO commenced the service without prior formal training in EUS-FNA. A formally trained colleague (MN) who underwent a fellowship in the same unit was appointed to a substantive post in 2007. The aims of the study were to assess if a dedicated training program in pancreaticobiliary (PB) EUS-FNA of solid lesions: (1) produced better results at the outset of independent practice than produced at the initiation of service without formal training and (2) produced results comparable with those of an experienced endosonographer.
  
  
  METHODS
  This is a retrospective review comparing the first 80 consecutive cases at the onset of practice of operator KO1 (2003/2004) and MN (2007/2008) as well as consecutive cases of operator KO2 (2007/2008) in the same time frame as the initial cases of operator MN.
  
  
  RESULTS
  There was a significant difference in EUS-FNA sensitivity for pancreatic malignancy between operator KO1 (56%) and operator MN (77%) p < 0.05. There was no significant difference in test performance between operator KO2 (82%) and MN (77%) (p > 0.05).
  
  
  CONCLUSIONS
  Our data show that formal training in PB EUS produces test performance at the outset of independent practice that is comparable with an experienced endosonographer, in line with the published standards for EUS-FNA of the pancreas and significantly better than that achieved without training.
authors.affiliation: HPB Unit, Freeman Hospital, Newcastle upon Tyne, UK. Manu.Nayar@nuth.nhs.uk
authors.forename: Manu
authors.initials: M
authors.lastname: Nayar
authors.forename: Diamond
authors.initials: D
authors.lastname: Joy
authors.forename: Viney
authors.initials: V
authors.lastname: Wadehra
authors.forename: Kofi
authors.initials: K
authors.lastname: Oppong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods*; D019160:Endosonography; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional