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Neel Sharma 3 Articles
Colonoscopy Procedure Time: Does the Learning Environment Matter?
Neel Sharma
Clin Endosc 2017;50(3):308-308.   Published online May 31, 2017
DOI: https://doi.org/10.5946/ce.2016.131
AbstractAbstract PDFPubReaderePub
Jain and colleagues pushed boundaries in their study by focusing on colonoscopy procedure time and the factors that may influence this [1]. Two of these factors included the level of experience of the endoscopist and the time of day with procedures performed in the afternoon associated with poorer outcomes. As a medical educationalist and gastroenterologist, I want to share scholarship with the academic community regarding current movements allied to the learning environment. Research is now emerging on the learning space in question to enhance competency [2]. Many case studies have indicated the value added in ensuring that the learning environment promotes appropriate engagement between learners and mentors, with workspaces that are technology specific to learning complimented with flipped learning approaches, team-based interactions, debriefing rooms, inter-professional discussions, writing spaces, and so on. This also has implications on the physical construct, with alterations in seating design to ensure this is optimized. The learning environment is a novel element to competency and, from a gastroenterologist’s perspective, is an often-overlooked facet. Research on the endoscopy center environment and its physicality may have relevance in endoscopy procedure performance and efficiency. Further work is needed in this regard.
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Insufficient Job Control among Gastroenterology Trainees: Time to Focus on the Science
Neel Sharma
Clin Endosc 2016;49(5):492-493.   Published online August 26, 2016
DOI: https://doi.org/10.5946/ce.2016.097
PDFPubReaderePub
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Raman Spectroscopy for the Endoscopic Diagnosis of Esophageal, Gastric, and Colonic Diseases
Neel Sharma, Nobuyoshi Takeshita, Khek Yu Ho
Clin Endosc 2016;49(5):404-407.   Published online September 22, 2016
DOI: https://doi.org/10.5946/ce.2016.100
AbstractAbstract PDFPubReaderePub
Globally white-light endoscopy with biopsy sampling is the gold standard diagnostic modality for esophageal, gastric, and colonic pathologies. However, there is overwhelming evidence to highlight the deficiencies of an approach based predominantly on eyeball visualization. Biopsy sampling is also problematic due in part to excessive sampling and hence attendant cost. Various innovations are currently taking place in the endoscopic domain to aid operators in diagnosis forming. These include narrow band imaging which aims to enhance the surface anatomy and vasculature, and confocal laser endomicroscopy which provides real time histological information. However, both of these tools are limited by the skill of the operator and the extensive learning curve associated with their use. There is a gap therefore for a new form of technology that relies solely on an objective measure of disease and reduces the need for biopsy sampling. Raman spectroscopy (RS) is a potential platform that aims to satisfy these criteria. It enables a fingerprint capture of tissue in relation to the protein, DNA, and lipid content. This focused review highlights the strong potential for the use of RS during endoscopic gastroenterological examination.

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