Prospective evaluation of a teaching model to determine competency in performing flexible sigmoidoscopies

There are limited objective criteria for determining competency in performing flexible sigmoidoscopies. The authors developed a teaching model using eight objective criteria that measured both cognitive and technical skills in performing flexible sigmoidoscopies. The objective was to determine whether the teaching model was a valid method and then to compare it to a commonly used Overall Competence Score or independent observer method.

A total of 120 procedures with 10 residents were evaluated using the two methods. Eight objective parameters had been determined before validating the teaching model. Preset criteria determined competency on a single procedure, and competent performance on five procedures in a row determined certification to independently perform procedures. The teaching model was separately tested for validity and then compared with the independent observer method.

A total of 120 procedures were graded using the teaching model method: 73 competent and 47 incompetent. Six of the seven objective parameters were associated with competency in the teaching model method. The eighth objective parameter was excluded because of lack of variation. Fifty of the 120 procedures were graded using the independent observer method: 36 competent and 14 incompetent. Two of the seven objective parameters were associated with competency in the independent observer method. Comparison of the two methods revealed seven discrepancies regarding competent and incompetent procedures. The correlation between the two methods was 0.71.

The teaching model method offers objective criteria to evaluate skill in performing flexible sigmoidoscopies.