Competency based medical education in gastrointestinal motility—the UK perspective

Gastrointestinal dysmotility: A qualitative exploration of the journey from symptom onset to diagnosis

“…A finding was the need for a more coherent understanding of GID by HPs which would help them to diagnose the condition sooner and help in validating participant experiences. Consistent with our patients reported experiences, recent studies in North America and the United Kingdom have recognized that medical education in gastrointestinal motility is deficient . It is, therefore, plausible that this lack of coverage of GID within training curricula could lead to delays in making confident diagnoses by non‐specialist HPs, especially given the non‐specificity of GID symptoms and lack of awareness could potentially lead to delays in referral to tertiary services.…”

“…Consistent with our patients reported experiences, recent studies in North America and the United Kingdom have recognized that medical education in gastrointestinal motility is deficient. [43][44][45][46][47] It is, therefore, plausible that this lack of coverage of GID within training curricula could lead to delays in making confident diagnoses by non-specialist HPs, especially given the non-specificity of GID symptoms 1 and lack of awareness could potentially lead to delays in referral to tertiary services. Similarly, in chronic fatigue syndrome, Chew-Graham et al 48 concluded that until HPs feel comfortable making a diagnosis and facilitating management of medically unexplained conditions, there will continue to be delays in confirming the diagnosis and patients will continue to not receive appropriate treatment.…”

Apprenticeship-based training in neurogastroenterology and motility

“…Recent surveys support our conclusions by highlighting the consequences of deficiencies in NGM training, whereby a majority of GI clinicians in UK are unable to independently interpret motility studies, and often struggle to provide therapeutic recommendations [7,8,9,15]. Consequently, there is little doubt that training in NGM would be invaluable for all GI trainees, as well as improve the quality of patient care.…”

“…Recently some efforts have been made to address these training deficiencies in the Whilst raising awareness via these educational forums will undoubtedly improve exposure, given the complexity of motility disorders and the technological advances and the steep learning curves for achieving competency in interpretation of motility procedures, similar to endoscopy training [15,16,17,18,19], a dedicated training program is essential.…”

“…With this in mind, Yadlapati et al recently developed and piloted a high resolution esophageal manometry 'interpretation exam' with eight interpretation skills per case and suggest that this computer-based assessment tool could be applied in clinical practice to judge competency of trainees [22]. This competency-based approach appears promising and is likely to be available to be used in conjunction with workplace based assessments including direct observed procedural assessments (DOPs) [15].…”