Capsule Endoscopy Elective
Tampa General Hospital
Capsule endoscopy is offered as an elective rotation for second and third year gastroenterology fellows. During the rotation, the fellow will have ample time to study the textbook for this rotation, “Atlas of Capsule Endoscopy,” and to review the literature on capsule endoscopy which is rapidly evolving. The fellow will also have the opportunity to read 30 to 50 capsule endoscopies (25 recommended by the ASGE to achieve certification). Most of these studies will be newly performed, but the fellow may also be asked to read studies done in the past to round out his/her experience. The fellow will also obtain hands on experience in the placement of small bowel capsules directly into the duodenum with endoscopy, and hands on experience with balloon enteroscopy. The fellow will administer patency capsules, perform follow-up fluoroscopy, and determine if a small bowel stenosis exists depending on the results. By the end of the rotation, the fellow will be certified to read capsule endoscopy, and to do patency capsule studies and balloon enteroscopy..
Goals and Objectives:
Medical Knowledge
The gastroenterology completing this rotation will have an in depth knowledge of the following:
1. The indications for and contraindications to small bowel and esophageal
capsule endoscopy.
2. The indications for and contraindications to balloon enteroscopy.
3. Normal small bowel anatomy, and the abnormalities associated with small bowel diseases.
4. The indications for patency capsule studies.
6. The operation of the hardware and software necessary to perform and interpret capsule endoscopy studies.
7. The treatment of small bowel disease including the indications for endoscopic and surgical therapy.
Patient Care
The gastroenterology fellow completing this rotation will be able to interpret and perform the following procedures:
1. Esophageal and small bowel capsule endoscopy studies.
2. Direct endoscopic placement of small bowel capsules.
3. Single balloon enteroscopy including techniques of biopsy, hemostasis, ablation, and tattooing of mucosal lesions .
4. Patency capsule studies.
Practice Based Learning and Improvement:
Gastroenterology fellows participating in this elective rotation will develop:
1. A critical approach to the capsule endoscopy literature to facilitate review and
assessment of the quality of reported scientific studies.
2. An ability to apply the methods used to assess quality of care and initiate
quality improvement projects for patients with obscure gastrointestinal and
small bowel disorders disorders..
3. A commitment to continous quality improvement in the delivery of care to
patients.
4. The ability to evaluate reported research and use the information obtained from
reviewing the literature to improve patient care.
4. The capability of using information technology to manage data on patients.
5. The ability to use information technology to enhance professional development
and continuing education.
6. A willingness to participate in the education of students, residents and other health care professionals involved in the care of patients with obscure gastrointestinal bleeding and small bowel disorders.
Systems Based Practice:
Gastroenterology fellows participating in this elective rotation will:
1. Be able to function as part of the capsule endoscopy team (includes nurse manager at USF, nursing staff at TGH, financial specialist, unit coordinator at Tampa General, and GI surgeon).
2. Be able to function as a patient advocate for individuals with obscure gastrointestinal bleeding and small bowel disorders.
3. Be able to participate in the multidisciplinary management of patients (medical, endoscopic, surgical and nursing care) with obscure gastrointestinal bleeding and small bowel disorders.
4. Be able to participate in development of improved techniques to deliver care to patients with obscure gastrointestinal bleeding and small bowel disorders.
Communication:
Gastroenterology fellows participating in this elective rotation will be able to:
1. Create and sustain a therapeutic and ethically sound relationship with patients
having obscure gastrointestinal bleeding and small bowel disorders
2. Communicate effectively with chronically ill patients and their families.
3. Work with others as an effective team member.
4. Counsel and educate patients and families concerning health issues relating to gastrointestinal bleeding and/or small bowel disorders.
Professionalism:
Gastroenterology fellows participating in this rotation will learn and/or demonstrate:
1. Respect, compassion and integrity in all interpersonal relationships.
2. A commitment to provide continued effort until patient care needs are completed or responsibility for them is transferred to another health care provider.
3. An understanding of diversity issues treating all patients with respect and consideration.
4. A commitment to the ethical principles pertaining to informed consent.
5. Accountability to patients, society and the profession.
6. A commitment to lifelong learning and continued professional development.
At the conclusion of the rotation, the fellow will have developed the following knowledge, skills and attitudes:
Knowledge:
1. The indications for and contrindications to capsule endoscopy
2. The indications for patency capsule studies
3. The indications for and contraindications to balloon enteroscopy
4. The appearance of normal small bowel mucosa, and the abnormalities seen
with small bowel disorders
5. A familiarity with the current literature on capsule endoscopy
Skills:
1. The ability to interpret esophageal and small bowel capsule endoscopy
2. The ability to do and interpret patency capsule studies
3. The ability to do balloon enteroscopy
4. The ability to place capsules directly into the duodenum using an endoscope
5. The ability to utilize the capsule endoscopy hardware and software
Attitudes:
1. A commitment to lifelong learning
2. A willingness to work with new technologies
3. A willingness to communicate with referring physicians and with patients
regarding the results of studies
4. A willingness to arrange follow-up care for patients
5. A willingness to educate colleagues and patients regarding the benefits and
limitations of capsule endoscopy and other new technologies
Evaluation
The gastroenterology fellow will be given a core competency evaluation by the attending gastroenterologist assigned to the capsule endoscopy service at the end of the rotation. In addition, an assessment will be made on the ability of the fellow to read capsule endoscopy, and to perform patency capsule studies and balloon enteroscopy.