Training to competency in colonoscopy: assessing and defining competency standards.

Area of Science:

• Medical Education
• Gastroenterology
• Endoscopic Training

Background:

• Defining and assessing colonoscopy competency has been a long-standing challenge for endoscopy experts.
• Establishing standardized training requirements is crucial for ensuring procedural proficiency.

Purpose of the Study:

• To evaluate methods for assessing core endoscopy skills in trainees.
• To define learning curves and competency thresholds for key colonoscopy parameters.

Main Methods:

• Prospective descriptive assessment of gastroenterology fellows' colonoscopy performance at Mayo Clinic.
• Utilized the Mayo Colonoscopy Skills Assessment Tool (MCSAT) to evaluate cognitive and motor skills.
• Established minimal competence thresholds using the contrasting groups method.

Main Results:

• Forty-one fellows performed 6,635 colonoscopies; 4,103 were assessed with MCSAT.
• An average MCSAT score of 3.5 was identified as the competency benchmark.
• Competency, defined by MCSAT scores, cecal intubation rates (85%), and intubation times (≤16 minutes), was achieved around 275 procedures.

Conclusions:

• Learning curves for core colonoscopy skills were successfully described.
• Recommended minimal competency criteria include an MCSAT score of 3.5, 85% cecal intubation rate, and intubation time under 16 minutes.
• Achieving colonoscopy competence averages 275 procedures, exceeding prior recommendations and current requirements in other specialties.