Exploring Endoscopic Competence in Gastroenterology Training: A Simulation-Based Comparative Analysis of GAGES, DOPS,...

Area of Science:

• Medical Education
• Gastroenterology
• Simulation-Based Training

Background:

• Accurate assessment tools are crucial for documenting endoscopic competence in gastroenterology training.
• Direct Observation of Procedural Skills (DOPS), Global Assessment of Gastrointestinal Endoscopic Skills (GAGES), and Assessment of Endoscopic Competency (ACE) are validated tools.
• A lack of comparative studies hinders standardization of endoscopy assessment.

Purpose of the Study:

• To determine the most reliable, comprehensive, and user-friendly tool for standardizing endoscopy competency assessment.
• To compare the psychometric properties and user experience of DOPS, GAGES, and ACE.
• To identify the optimal assessment tool for gastroenterology training programs.

Main Methods:

• A mixed-methods approach using a high-fidelity simulator (Simbionix Gi-bronch-mentor).
• Nine trainees were assessed by two faculty raters using DOPS, GAGES, and ACE.
• Psychometric analysis (Cronbach's alpha, inter-rater reliability) and faculty focus group discussions were conducted.

Main Results:

• For upper GI endoscopy, GAGES showed the highest internal consistency (0.87), while ACE had the highest inter-rater reliability (0.79).
• For colonoscopy, DOPS demonstrated strong internal consistency (0.82) and good inter-rater reliability (0.78).
• Faculty feedback highlighted the need for tools that are scientifically sound, comprehensive, and user-friendly.

Conclusions:

• The Direct Observation of Procedural Skills (DOPS) tool emerged as the most balanced, performing well in both psychometric evaluation and qualitative feedback.
• DOPS is recommended for endoscopic skill assessment in gastroenterology training.
• Training programs should align learning outcomes with assessment tool capabilities for optimal implementation.