title: Training endosonographers in cytopathology: improving the results of EUS-guided FNA.
abstract: BACKGROUND
  Although on-site cytopathology services have a significant impact on efficiency and accuracy of EUS-guided FNA (EUS-FNA), the availability of this service is variable.
  
  
  OBJECTIVE
  To evaluate the impact of an intensive 2-day training program to educate endosonographers in EUS-related cytopathology.
  
  
  METHODS
  Pilot study.
  
  
  METHODS
  Tertiary care medical center.
  
  
  METHODS
  Six endosonographers (5 male, median age, 35 years) with minimal previous cytopathology exposure comprised the study cohort.
  
  
  METHODS
  Pre- and posttraining testing was administered. Training commenced with a cytopathology tutorial focusing on 4 performance measures: specimen adequacy, sample interpretation, specimen processing, and preliminary diagnosis. Eight live EUS-FNA cases were then performed, and study participants independently completed 4 questions based on performance measures for each case. The ability to independently smear and stain slides and operate a microscope was additionally assessed after a hands-on tutorial.
  
  
  METHODS
  Comparison of pretraining and posttraining scores, improvement in performance measures for live cases, and ability to independently handle specimens and operate a microscope.
  
  
  RESULTS
  Compared with pretraining, mean posttraining test scores improved by 63% from 48 to 78 out of 100. Mean live case performance score was 95%. Performances improved from 89% on day 1 to 100% on day 2. After training, all endosonographers could independently smear/stain slides and operate a microscope.
  
  
  CONCLUSIONS
  Long-term impact is unclear.
  
  
  CONCLUSIONS
  An intensive 2-day program was effective in training endosonographers in the basics of EUS-related cytopathology. Incorporating basic cytopathology in EUS fellowship curriculum will likely improve diagnostic performance of tissue acquisition procedures.
authors.affiliation: Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida, USA.
authors.forename: Shyam
authors.initials: S
authors.lastname: Varadarajulu
authors.affiliation: Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida, USA.
authors.forename: Bronte A
authors.initials: BA
authors.lastname: Holt
authors.affiliation: Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, Indiana, USA.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Bang
authors.affiliation: Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida, USA.
authors.forename: Muhammad K
authors.initials: MK
authors.lastname: Hasan
authors.affiliation: Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Logue
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Tamhane
authors.affiliation: Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Hawes
authors.affiliation: Department of Pathology, Florida Hospital, Orlando, Florida, USA.
authors.forename: Shantel
authors.initials: S
authors.lastname: Hebert-Magee
mesh_terms: D000328:Adult; D004502:Education, Medical, Continuing / Q000379:methods*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000592:standards*; D019160:Endosonography; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology*; D005762:Gastroenterology / Q000193:education*; D006801:Humans; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D010181:Pancreatic Cyst / Q000473:pathology; D010182:Pancreatic Diseases / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000473:pathology; D050500:Pancreatitis, Chronic / Q000473:pathology; D010336:Pathology / Q000193:education*; D010865:Pilot Projects; D058996:Quality Improvement; D013048:Specimen Handling