Training endosonographers in cytopathology: improving the results of EUS-guided FNA

Gastrointest Endosc. 2015 Jan;81(1):104-10. doi: 10.1016/j.gie.2014.07.026. Epub 2014 Aug 12.

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.

Design: Pilot study.

Setting: Tertiary care medical center.

Subjects: 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.

Main outcome measurements: 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.

Limitations: 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.

MeSH terms

  • Adult
  • Education, Medical, Continuing / methods*
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / standards*
  • Endosonography*
  • Female
  • Gallbladder Neoplasms / pathology*
  • Gastroenterology / education*
  • Humans
  • Male
  • Microscopy
  • Middle Aged
  • Pancreatic Cyst / pathology
  • Pancreatic Diseases / pathology*
  • Pancreatic Neoplasms / pathology
  • Pancreatitis, Chronic / pathology
  • Pathology / education*
  • Pilot Projects
  • Quality Improvement*
  • Specimen Handling