Non-technical skills in the management of endoscopic adverse events

Adverse events are an inherent risk of performing endoscopic procedures. Although the rate of serious adverse events during routine endoscopic procedures is relatively low, most gastroenterologists will encounter at least one significant adverse event during their careers. Traditional endoscopic training largely focuses on teaching the technical management of adverse events with less emphasis on the cognitive and interpersonal competencies that are critical to patient safety. Increasing attention has therefore been directed toward endoscopic non-technical skills (ENTS) and their role in preventing and managing endoscopy-related adverse events. ENTS embody the cognitive and social skills needed to perform high-quality patient care during endoscopic procedures. The major categories of ENTS include communication, teamwork, situational awareness, leadership, judgment and decision making, and professionalism. Deficiencies in ENTS could potentially lead to endoscopy-related patient safety incidents. The aim of this review is to explore the key domains of ENTS and their relevance in the management of endoscopy-related adverse events. The review will additionally examine educational strategies to improve ENTS including simulation-based training, structured curricula, and team-focused interventions. Future research is needed to develop validated ENTS assessment tools and evaluate standardized training programs to improve ENTS. Strengthening ENTS education may ultimately improve patient safety and outcomes in endoscopic practice.