Catharine M. Walsh, MD, MEd, FRCPC from The Hospital for Sick Children and the Wilson Centre for Research in Education at the University of Toronto in Toronto, Canada discusses her Original Article “Gastrointestinal Endoscopy Competency Assessment Tool: development of a procedure-specific assessment tool for colonoscopy.”
The main purpose of this study was to develop and establish the content validity of a new measure of endoscopic competence that is reflective of practice across institutions, the Gastrointestinal Endoscopy Competency Assessment Tool (GiECAT). The GiECAT was designed to assess the full breadth of technical, cognitive, and integrative competencies required to perform pre-, post- and intra-procedural elements of colonoscopy.
The current shift in postgraduate medical education training from a time- and process-based system to an outcomes-based approach, centered on the achievement of core training competencies or milestones, has highlighted the need for the development of a measure of endoscopic competence capable of assessing endoscopists’ skills across the learning trajectory, from novice to experienced endoscopist. In addition, the move towards competency-based outcomes training and assessment has emphasized the need to assess all facets of endoscopic competence. Aside from the technical aspects of procedural learning, there are key cognitive and integrative skills, such as clinical judgment and communication, that are required to perform colonoscopy safely and proficiently.
In order to develop the GiECAT, an international panel of 55 endoscopy experts from 44 centers internationally rated a comprehensive list of potential checklist and global rating items for their importance as indicators of the competence of trainees learning to perform colonoscopy. Through iterative rounds of Delphi surveys 75 checklist and 38 global rating items were reduced to 19 checklist and 7 global rating items that reached consensus as being most important to include in the GiECAT assessment tool.
Delphi methodology allowed for the rigorous development and content validation of the GiECAT, a new measure of endoscopic competence that is reflective of practice across institutions. The GiECAT was designed to assess the full breadth of skills required to perform colonoscopy, including performance of pre- and post-procedural elements. Studies are currently underway to assess the reliability, validity and responsiveness of the GiECAT in both the clinical and simulated settings, its relationship to other performance indicators such as completion rates, and ease of use.
Read the article abstract online here.
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