Assessing resident performance and training of colonoscopy in a general surgery training program

Area of Science:

• Medical Education
• Surgical Training
• Gastroenterology

Background:

• Concerns exist regarding the adequacy of endoscopy training in general surgery residencies.
• Ongoing efforts aim to enhance resident endoscopic training and assess competency.
• This study evaluates resident colonoscopy performance using objective assessment tools.

Purpose of the Study:

• To assess the performance of general surgery residents in colonoscopy.
• To evaluate the effectiveness of two assessment tools in measuring resident competency.
• To determine if resident skill improves with increasing postgraduate year (PG-Y) level.

Main Methods:

• Prospectively collected data from 100 colonoscopies performed by residents between September 2008 and June 2011.
• Residents were graded by attending surgeons using two distinct assessment tools post-procedure.
• Patient demographics, procedural data, outcomes, and assessment scores were analyzed.

Main Results:

• Postgraduate Year 3 residents performed 72% of colonoscopies, with average resident participation of 73%.
• Colonoscopy completion rate was 90%, with a 3% morbidity rate (including perforation and post-polypectomy bleeding).
• Objective assessment tools indicated an overall improvement in resident skill with increasing PG-Y level.

Conclusions:

• Objective assessment tools suggest that resident colonoscopy skills generally improve with higher PG-Y levels.
• Not all measured skill categories showed improvement, indicating variability in learning.
• Further research is needed to refine and evolve methods for assessing surgical resident competency in colonoscopy.