Competency assessment for gastric endoscopic submucosal dissection using an endoscopic part-task training box

• Published in: Surgical endoscopy Vol. 33; no. 8; pp. 2548 - 2552
• Main Authors: Tamai, Naoto, Aihara, Hiroyuki, Kato, Masayuki, Isshi, Kimio, Sumiyama, Kazuki
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.08.2019; Springer Nature B.V
• Subjects: Abdominal Surgery; Clinical Competence; Educational Measurement - methods; Endoscopic Mucosal Resection - education; Endoscopic Mucosal Resection - methods; Endoscopy; Gastric Mucosa - surgery; Gastroenterology; Gynecology; Hepatology; Humans; Intubation; Medicine; Medicine & Public Health; Occupational training; Physicians; Proctology; Surgery; Teaching; Training; Endoscopic submucosal dissection (ESD); Endoscopy; Thompson Endoscopic Skills Trainer; Competency
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-018-6548-7

Background Objective assessment of endoscopist competency is important. Recently, the endoscopic part-task training box (Thompson Endoscopic Skills Trainer [TEST]) was developed to assess endoscopist competency. We aimed to evaluate the ability of the TEST to assess competency during endoscopic procedures, especially endoscopic submucosal dissection (ESD). Methods Twenty-three physicians were included in this study. Correlations between TEST scores and the following factors were evaluated: years of endoscopic experience, number of esophagogastroduodenoscopies (EGDs) performed, number of colonoscopies (CSs) performed, cecal intubation rate, number of gastric ESDs performed, gastric ESD procedure time/lesion size (min/mm 2 ), and gastric ESD self-completion rate. Also, correlation coefficients between the number of gastric ESDs performed and each of gastric ESD procedure time/lesion size and gastric ESD self-completion rate were calculated. Results TEST scores showed strong correlations to different factors: years of experience in endoscopy: 0.957 ( p  < 0.01); number of EGDs: 0.947 ( p  < 0.01); number of CSs: 0.947, ( p  < 0.01); number of gastric ESDs: 0.924 ( p  < 0.01); gastric ESD procedure time/lesion size: − 0.9 ( p  < 0.01); self-completion rate of gastric ESDs: 0.857 ( p  < 0.005). The number of gastric ESDs performed was not more strongly correlated to procedure time of gastric ESDs or self-completion rate of gastric ESDs compared to TEST scores (− 0.824 ( p  < 0.01) and 0.704 ( p  < 0.05), respectively). TEST scores of endoscopists with a cecal intubation rate ≥ 90% were > 380, while the scores of physicians with a gastric ESD self-completion rate ≥ 90% were > 700. Conclusions TEST score correlates with both basic and advanced endoscopic procedures. TEST is therefore a promising option for assessing endoscopist competency, and might be useful for providing threshold scores as competency markers for specific endoscopic procedures such as gastric ESD.