ASGE Postgraduate Course at ACG: Innovative Practices for the Endoscopist of Today, Tomorrow and Beyond | October 2023-15_Shah Updates in Assessing Competency in Endoscopy

15_Shah Updates in Assessing Competency in Endoscopy

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Dr. Brijen J. Shah presented updates on assessing competency in endoscopy, emphasizing the tools and methodologies currently used to evaluate skills in both trainees and practicing physicians. The presentation defines competency as an observable ability integrating knowledge, skills, values, and attitudes as per the International CBME Collaborators.<br /><br />**Current Assessment Tools:**<br />Tools like the NASPGHAN Pediatric Training EGD and Colonoscopy Tools, GAGES, ACE EGD Skills Assessment Tool, and more, are acknowledged for their roles in competency assessment. Entrustable Professional Activities (EPAs) also outline necessary skills and knowledge, with two notable EPAs being:<br />- EPA 6: For general endoscopic evaluation and intervention.<br />- EPA 7: For managing gastrointestinal bleeding.<br /><br />**Assessment Frameworks and Models:**<br />The presentation refers to the Dreyfus Model, delineating a progression from novice to master, utilized to assess the development of endoscopic skills. Competency Milestones in GI (2.0) markers track this progression.<br /><br />**Updates for Fellows:**<br />Innovations include a robust curriculum involving online tests, practical sessions, and clinical rotations. Evidence suggests significant improvements in skill assessment scores among fellows. Specific programs like metric-based training for proficiency in simulation are validated for upper GI endoscopy.<br /><br />**Simulation and Competency Assessments:**<br />Simulation has proven effective in enhancing sedation knowledge and managing new sedation procedures, with formative and summative assessments ensuring comprehensive competency evaluation.<br /><br />**Non-Technical Skills:**<br />Non-technical skills (NTS) such as situational awareness, leadership, communication, and professionalism are also critical for comprehensive competency assessment. Various tools and 360-degree evaluations help in assessing these skills.<br /><br />**Assessment for Practicing Physicians:**<br />The process includes case volume reviews, quality assessments, and periodic evaluations ensuring ongoing competency. Variable guidelines on privileging require attention to quality and non-technical skills assessment.<br /><br />**Future Directions:**<br />Concluding, Shah highlights the need for regular reflection on assessment practices, discerning their purpose for learning or high-stakes decisions, and emphasizes the continuous evolution towards competency-based skill development. Further research is suggested, particularly on the role of simulation in practical assessments.

Keywords

endoscopy competency

assessment tools

EPAs

Dreyfus Model

GI Milestones

simulation training

non-technical skills

practicing physicians

quality assessments

future directions