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Quality evaluation through self-assessment: a novel method to gain insight into ERCP performance.

ABSTRACT: The American Society for Gastrointestinal Endoscopy Committee on Outcomes Research has recommended monitoring nine endoscopic retrograde cholangiopancreatography (ERCP)-specific quality indicators for quality assurance in ERCP. With the development of a self-assessment tool for ERCP (Rotterdam Assessment Form for ERCP-RAF-E), key indicators can easily be assessed.The aim of this study was to test in daily practice an easy-to-use form for assessment of procedural quality in ERCP and to determine ERCP quality outcomes in a tertiary referral hospital.This was a prospective study carried out in a tertiary referral hospital. In January 2008, a quality self-assessment programme was started. Five qualified endoscopists participated in this study. All ERCPs were appraised using RAF-E. Primary parameters were common bile duct (CBD) cannulation rate and procedural success. The indication was classified and procedural difficulty was graded; success rates of therapeutic interventions were measured for all different difficulty degrees.A total number of 1691 ERCPs were performed. 1515 (89.6%) of these were appraised using RAF-E. Median CBD cannulation success rate was 94.1%. Successful sphincterotomy was accomplished in almost all patients (median 100%; range 98.2-100%). Stent placement was successful in 97.8% and complete stone extraction, if indicated, was achieved in 86.8%.Quality indicators for ERCP can be measured using the Rotterdam self-assessment programme for ERCP. Outcome data in ERCPs obtained with this RAF-E provide insight into the quality of individual as well as group performance and can be used to assess and set standards for quality control in ERCP.

SUBMITTER: Ekkelenkamp VE

PROVIDER: S-EPMC3880906 | biostudies-other | 2014 Jan

REPOSITORIES: biostudies-other

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Project description:In common with other professional musicians, self-evaluation of practise and performance is an integral part of a pianist's professional life. They will also have opportunities to listen to and evaluate the performances of others based on their own criteria. These self-constructed perspectives towards to a piano performance will have an influence on both self-evaluation and external evaluation, but whether differently or similarly is not known. Consequently, this research study aimed to explore how judgements on the perceived quality of a performance are undertaken by professional standard pianists and what criteria are applied, both with regards their own performances as well as the performance of others. Participants were six professional pianists (3 men, 3 women) who were based in the United Kingdom (Mean age = 31.5 years old. SD = 5.1). They were asked to play individually six trials of a piece of R. Schumann's "Träumerei" Op. 15 No. 7 in a hired hall for recordings. Then, within 2 months, each participant was asked to come to a self-evaluation session to listen to and evaluate their own six recordings, using a Triadic method as a Repertory Grid. For the external evaluation focused session, the participants were asked to return again to evaluate a further six recordings made up of 'best' recordings as selected by each participant from their own individual self-evaluations. Analyses of the resultant data suggest that there was no significant difference between the participants in their overall ratings in the external phase, but that self-evaluation showed significant individual differences amongst several participants. The performance criteria in both self-evaluation and external evaluation predominately overlapped with each other in terms of musical factors, such as tone quality, phrasing, and pedalling. The ranking of the performances was highly correlated with perceptions of overall flow, tone quality and pedalling. It appears that pianists apply similar criteria to decide performance quality when evaluating their own performances as well as others.

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Quality evaluation through self-assessment: a novel method to gain insight into ERCP performance.

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