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

Area of Science:

• Gastroenterology and Endoscopy
• Medical Education and Training
• Surgical Skills Assessment

Background:

• Objective assessment of endoscopist competency is crucial for patient safety and procedural outcomes.
• The Thompson Endoscopic Skills Trainer (TEST) was developed as a tool for evaluating endoscopic proficiency.
• This study specifically investigated the TEST's ability to assess competency in advanced procedures, particularly endoscopic submucosal dissection (ESD).

Purpose of the Study:

• To evaluate the efficacy of the Thompson Endoscopic Skills Trainer (TEST) in assessing endoscopist competency.
• To determine the correlation between TEST scores and various experience-based and performance-based metrics in endoscopy.
• To explore the potential of TEST scores as markers for specific endoscopic procedures like gastric ESD.

Main Methods:

• Twenty-three physicians participated in the study.
• Correlations were analyzed between TEST scores and factors including years of endoscopic experience, number of esophagogastroduodenoscopies (EGDs) and colonoscopies (CSs) performed, cecal intubation rate, and gastric ESD metrics (number performed, procedure time/lesion size, self-completion rate).

Main Results:

• TEST scores demonstrated strong positive correlations with years of endoscopic experience (0.957), number of EGDs (0.947), CSs (0.947), and gastric ESDs performed (0.924).
• A strong negative correlation was observed between TEST scores and gastric ESD procedure time/lesion size (-0.9), and a strong positive correlation with gastric ESD self-completion rate (0.857).
• Established thresholds for high competency were identified: TEST scores >380 for a cecal intubation rate ≥90% and >700 for a gastric ESD self-completion rate ≥90%.

Conclusions:

• The TEST score significantly correlates with both basic and advanced endoscopic procedural skills.
• The TEST is a promising tool for objective assessment of endoscopist competency.
• The study suggests that TEST can provide valuable threshold scores to serve as competency markers for specific procedures, such as gastric ESD.