Introduction Endoscopic non-technical skills (ENTS), comprising of communication and teamwork, situation awareness, leadership, and judgement and decision-making, are recognised indicators of quality endoscopy and patient safety. Since July 2016, electronic assessment forms (DOPS) for UK trainee endoscopists have been updated to include ENTS as an assessable domain. We aimed to explore the uptake and distribution of ENTS scoring in DOPS and their correlation with other endoscopic skills.
Method We identified all DOPS submitted between July 2016 and Feb 2017 from the national trainee database (JETS) and acquired data on trainees, procedures and scores. We collated scores for each of the 4 assessable domains (pre-procedural, procedural, post-procedural and ENTs) into overall outcomes of “not competent” (if any domain items required supervision) or “competent”, and compared this to the overall competence rating. Statistical analysis was performed using chi2 and regression modelling.
Results 8601 DOPS were prospectively collected, with ENTS assessed in 99.3%. Overall competency rates in ENTS varied across procedures (p<0.001): ERCP 39.8%, EUS 44.1%, gastroscopy 59.6%, colonoscopy 62.3%, PEG 71.1%, gastrointestinal bleed (71.5%), sigmoidoscopy 72.4% and polypectomy 73.2%. Of DOPS awarded overall competency, 5.9% (240/4077) lacked full competence in ENTS (p=0.10 across modalities). Across trainee specialties and endoscopic modalities, competence was greatest for “communication and teamwork” (77.1% overall), but least with ‘judgement and decision making’ (68.3%). Competency in ENTS increased with lifetime procedural count (OR 1.008 per increase in procedure, p<0.001), and correlated strongly with other assessable domains (Figure 1), including overall score (p<0.001). After adjusting for procedural count, factors predictive of ENTS competence included trainee seniority (odds ratio [OR] for ST5 level: 1.96, p<0.0001), surgical trainees (OR 1.21, p=0.014), trainees performing polypectomy (OR 2.02, p<0.0001), and higher DOPS count (OR 1.03 per increase in DOPS, p<0.001).
Conclusion ENTS is an assessable domain within endoscopy training, with scores that correlate with other procedure-related skills, demonstrating construct validity of the ENTS scoring system. Competency of ENTS develop with procedural count, and vary with trainee seniority and specialty. Longer term data are required to assess the impact of ENTS on certification.
Disclosure of Interest None Declared
- endoscopy training