Colonoscopy Direct Observation of Procedural Skills Assessment Tool for Evaluating Competency Development During Training

Siau, Keith; Crossley, James; Dunckley, Paul; Johnson, Gavin; Feeney, Mark; Iacucci, Marietta; Anderson, John T.

doi:10.14309/ajg.0000000000000426

Cited by 27 publications

(43 citation statements)

References 28 publications

(35 reference statements)

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“…32,33 Second, determination of competence should rely less on attaining minimum numbers and more on the use of objective and validated methods of competency assessment. This is best achieved through the use of objective performance tools with strong validity evidence, such as the Assessment of Competency in Endoscopy, 34 Direct Observation of Procedural Skills, [35][36][37] and the Gastrointestinal Endoscopy Competency Assessment Tool, 38 which can allow trainers to target feedback provision in a formative manner and to benchmark global competence for summative signoff. 35 Despite these measures, it may be necessary for some trainees to extend their endoscopy training.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on endoscopy trainees: an international survey

Pawlak

Král

Khan

et al. 2020

Gastrointestinal Endoscopy

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139

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Background and Aims: Although coronavirus disease 2019 (COVID-19) has affected endoscopy services globally, the impact on trainees has not been evaluated. We aimed to assess the impact of COVID-19 on procedural volumes and on the emotional well-being of endoscopy trainees worldwide. Methods: An international survey was disseminated over a 3-week period in April 2020. The primary outcome was the percentage reduction in monthly procedure volume before and during COVID-19. Secondary outcomes included potential variation of COVID-19 impact between different continents and rates and predictors of anxiety and burnout among trainees. Results: Across 770 trainees from 63 countries, 93.8% reported a reduction in endoscopy case volume. The median percentage reduction in total procedures was 99% (interquartile range, 85%-100%), which varied internationally (P < .001) and was greatest for colonoscopy procedures. Restrictions in case volume and trainee activity were common barriers. A total of 71.9% were concerned that the COVID-19 pandemic could prolonged training. Anxiety was reported in 52.4% of respondents and burnout in 18.8%. Anxiety was independently associated with female gender (odds ratio [OR], 2.15; P < .001), adequacy of personal protective equipment (OR, 1.75; P Z .005), lack of institutional support for emotional health (OR, 1.67; P Z .008), and concerns regarding prolongation of training (OR, 1.60; P Z .013). Modifying existing national guidelines to support adequate endoscopy training during the pandemic was supported by 68.9%. Conclusions: The COVID-19 pandemic has led to restrictions in endoscopic volumes and endoscopy training, with high rates of anxiety and burnout among endoscopy trainees worldwide. Targeted measures by training programs to address these key issues are warranted to improve trainee well-being and support trainee education.

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Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on endoscopy trainees: an international survey

Pawlak

Král

Khan

et al. 2020

Gastrointestinal Endoscopy

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139

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“…During hands-on sessions, trainees are subjected to rigorous performance review of technical aspects, e.g ., scope handling, loop avoidance and resolution, to non-technical skills[ 21 ], e.g ., situational awareness, which can impact on progress and patient comfort. Tailored high-performance feedback, based on the DOPS formative assessment tool[ 22 ], is provided for each trainee and backed by future goal setting to encourage practice changes within their usual training environment. In contrast, CIR analyses showed a significant benefit only in those at earlier stages of training (< 70 procedures).…”

Section: Discussionmentioning

confidence: 99%

Impact of a national basic skills in colonoscopy course on trainee performance: An interrupted time series analysis

Siau

Hodson²,

Anderson

et al. 2020

WJG

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BACKGROUND The Joint Advisory Group on Gastrointestinal Endoscopy basic skills in colonoscopy (BSC) course was introduced in 2009 to improve colonoscopy training within the United Kingdom, but its impact on trainee performance is unknown. AIM To assess whether attendance of the BSC could improve colonoscopy performance. METHODS Trainees awarded colonoscopy certification between 2011-2016 were stratified into 3 groups according to pre-course procedure count (< 70, 70-140 and > 140). Study outcomes, comprising the unassisted caecal intubation rate (CIR) and the performance indicator of colonic intubation (PICI), were studied over the 50 procedures pre and post- course. Interrupted time series analyses were performed to detect step-change changes attributable to the course. RESULTS A total of 369 trainees with pre-course procedure counts of < 70 ( n = 118), 70-140 ( n = 121) and > 140 ( n = 130) were included. Over the 50 pre-course procedures, significant linear improvements in CIR were found, with average increases of 4.2, 3.6 and 1.7 percentage points (pp) per 10 procedures performed in the < 70, 70-140 and > 140 groups respectively (all P < 0.001). The < 70 procedures group saw a significant step-change improvement in CIR, increasing from 46% in the last pre-course procedure, to 51% in the first procedure post-course ( P = 0.005). The CIR step-change was not significant in the 70-140 (68% to 71%; P = 0.239) or > 140 (86% to 87%; P = 0.354) groups. For PICI, significant step-change improvements were seen in all three groups, with average increases of 5.6 pp ( P < 0.001), 5.4 pp ( P = 0.003) and 3.9 pp ( P = 0.014) respectively. CONCLUSION Attendance of the BSC was associated with a significant step-change improvement in PICI, regardless of prior procedural experience. However, CIR data suggest that the optimal timing of course attendance appears to be at earlier stages of training (< 70 procedures).

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“…DOPS [25][26][27] GiECAT [33][34][35][36] Description of tool ACE/MCSAT [20][21][22][23] DOPS [25][26][27] GiECAT [33][34][35][36] Internal structure…”

Section: Ace/mcsat [20-23]mentioning

confidence: 99%

Colonoscopy competence assessment tools: a systematic review of validity evidence

et al. 2021

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Background: Assessment tools are essential for endoscopy training, required to support feedback provision, optimize learner capabilities, and document competence. We aimed to evaluate the strength of validity evidence that supports available colonoscopy direct observation assessment tools using the unified framework of validity. Methods: We systematically searched five databases for studies investigating colonoscopy direct observation assessment tools from inception until April 8, 2020. We extracted data outlining validity evidence from the five sources (content, response process, internal structure, relations to other variables, and consequences) and graded the degree of evidence, with a maximum score of 15. We assessed educational utility using an Accreditation Council for Graduate Medical Education framework and methodological quality using the Medical Education Research Quality Instrument (MERSQI). Results: From 10,841 records, we identified 27 studies representing 13 assessment tools (10 adult, 2 pediatric, 1 both). All tools assessed technical skills, while 10 assessed cognitive and integrative skills. Validity evidence scores ranged from 1-15. The Assessment of Competency in Endoscopy (ACE) tool, the Direct Observation of Procedural Skills (DOPS) tool, and the Gastrointestinal Endoscopy Competency Assessment Tool (GiECAT) had the strongest validity evidence, with scores of 13, 15, and 14, respectively. Most tools were easy to use and interpret and required minimal resources. MERSQI scores ranged from 9.5-11.5 (maximum score 14.5). Conclusions: The ACE, DOPS, and GiECAT have strong validity evidence compared to other assessments. Future studies should identify barriers to widespread implementation and report on use of these tools in credentialing examinations.

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Colonoscopy Direct Observation of Procedural Skills Assessment Tool for Evaluating Competency Development During Training

Cited by 27 publications

References 28 publications

Impact of COVID-19 on endoscopy trainees: an international survey

Impact of COVID-19 on endoscopy trainees: an international survey

Impact of a national basic skills in colonoscopy course on trainee performance: An interrupted time series analysis

Colonoscopy competence assessment tools: a systematic review of validity evidence

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