Factors Associated With Pass-Fail Outcomes in the Colorectal Endoscopic Surgical Skill Qualification Examination: A...

Area of Science:

• Surgical Education and Training
• Endoscopic Surgery Assessment
• Medical Simulation and Skill Evaluation

Background:

• Objective assessment of surgical technical skills is crucial for patient safety and high-quality care.
• The Japan Society for Endoscopic Surgery (JSES) Endoscopic Surgical Skill Qualification (ESSQ) System standardizes endoscopic surgery.
• Factors influencing pass-fail outcomes in the ESSQ examination remain unevaluated.

Purpose of the Study:

• To comprehensively evaluate factors associated with pass-fail outcomes in the JSES ESSQ Examination.
• To identify predictors of successful qualification in endoscopic surgery.

Main Methods:

• Retrospective observational study of colorectal endoscopic surgical skill qualification examinations (2020-2024).
• Analysis of applicant, institutional, patient, tumor, surgical, and reviewer variables.
• Uni- and multivariable analyses to assess associations with pass-fail outcomes.

Main Results:

• Overall pass rate was 33.2% across 1945 applications.
• Independent predictors of successful qualification included fewer attempts, larger hospital bed capacity, 3D scope use, shorter operative time, and lower blood loss (p < 0.05).
• Reviewer demographics did not correlate with outcomes; reviewer agreement was 68.1% (Cohen's kappa = 0.336).

Conclusions:

• This study identified key applicant and institutional characteristics influencing ESSQ examination success.
• Operative performance indicators significantly impact qualification outcomes.
• Reviewer demographics showed no association with examination results.