Concordance Between Trainee Self-Assessment and Expert Assessment of Cold Snare Polypectomy Competence: Results From...

Area of Science:

• Gastroenterology
• Medical Education
• Endoscopic Procedures

Background:

• Cold snare polypectomy (CSP) competency is crucial for gastroenterology trainees.
• Current assessment tools may require longer observation periods, limiting their use in busy practices.
• Trainee self-assessment accuracy for CSP competence needs evaluation.

Purpose of the Study:

• To evaluate the concordance between trainee self-assessment and expert assessment of CSP competence.
• To identify factors influencing the agreement between trainee and expert evaluations.
• To assess the utility of self-assessment in competency-based endoscopy training.

Main Methods:

• Video recordings of 2,267 CSPs performed by 22 trainees across two institutions were reviewed.
• Eight blinded experts from four institutions rated procedures using the Cold Snare Polypectomy Assessment Tool (CSPAT).
• Trainees provided immediate post-procedure self-assessments of their competence.

Main Results:

• Overall concordance between trainee and expert assessment was 60.9% (weighted κ = 0.12).
• Trainees underassessed competence in 23.9% and overassessed in 15.3% of procedures.
• Factors associated with lower concordance included a career plan for private practice and lower prior colonoscopy volume.

Conclusions:

• There is a significant lack of concordance between trainee self-assessment and expert evaluation of CSP skills.
• Self-assessment can serve as a preliminary step, but must be reconciled with expert assessments for accurate competency evaluation.
• Structured feedback did not improve concordance but reduced overestimations by trainees.