JAG consensus statements for training and certification in colonoscopy.

Area of Science:

• Gastroenterology
• Medical Education
• Endoscopic Training

Background:

• Endoscopy certification in the UK requires trainees to meet minimum competency standards for independent practice.
• A national review was conducted to update and develop evidence-based standards for colonoscopy training and certification.

Purpose of the Study:

• To update and develop evidence-based standards and recommendations for colonoscopy training and certification in the UK.
• To establish revised criteria for colonoscopy certification.

Main Methods:

• A modified Delphi process involving multisociety expert representation was conducted between 2019 and 2020.
• Literature review and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) appraisal informed the formulation of recommendation statements.
• Statements were subjected to anonymous voting for consensus and peer-reviewed by the Joint Advisory Group (JAG) and stakeholders.

Main Results:

• Forty-five recommendation statements were generated across four domains: definition, acquisition, assessment of competence, and post-certification support.
• Revised criteria include achieving key performance indicators (e.g., caecal intubation rate >90%, polyp detection rate >15%), a minimum of 280 procedures, and specific skills assessments.
• Requirements encompass attendance of the JAG Basic Skills in Colonoscopy course, terminal ileal intubation rates, direct observation of procedure and polypectomy skills (SMSA level 2), reflective practice, and summative assessments.

Conclusions:

• Updated UK standards establish a single-stage colonoscopy certification process.
• The revised standards place a strong emphasis on polypectomy competency, specifically Size, Morphology, Site, Access (SMSA) Level 2+.
• These updated standards aim to support training, enhance colonoscopy and polypectomy quality, and provide support for newly independent practitioners.