Core curriculumColonoscopy core curriculum
Introduction
Identifying the skills required to perform colonoscopy safely, effectively, and comfortably is the aim of this document. Specifics on training and competency assessment of these skills are also covered. Additional information on endoscopy training can be found in the ASGE's āPrinciples of Training in Gastrointestinal Endoscopyā and the combined professional societies' core curriculum.1, 2 These core documents are pertinent and are recommended to colonoscopy trainers and trainees alike.
Section snippets
Goals of Training
Trainees are required to learn how to maximize visualization of the colonic and terminal ileal mucosa, minimize patient discomfort, and ensure the appropriate identification, removal, or ablation of lesions and other therapeutic techniques. These skills come with mastery of the individual core elements of the procedure. The core technical and cognitive skills are listed in Table 1 and are covered in detail. The core skills to be covered can also be classified by the Accreditation Council for
Duration of training
The duration of colonoscopy training needed to achieve minimal competence in colonoscopy varies from one trainee to another. It is well understood that simply completing some absolute number of procedures or training for some duration does not ensure competence, but these estimates can be helpful to training programs in determining how much time and resources are devoted to colonoscopy training to ensure all of a program's trainees can achieve basic competence. Recent research has supported
Assessment of competence
An important, but often overlooked, part of colonoscopy training is assessing the trainees to ensure that the requisite skills have been acquired. Traditional assessment has typically been based on rather informal global pass/fail type evaluations performed near the end of training. This has continued despite more than a decade of experts calling for ongoing objective skills assessment. This is primarily because of the difficulty of defining what constitutes competence in both the cognitive and
Disclosure
Dr McHenry, Consultant for Conmed Endoscopic Technology, Boston Scientific; Honorarium, Cook Endoscopy; Dr Shami, Consultant, Olympus America; Dr DiMaio, Consultant, Boston Scientific Corp. All other authors disclosed no financial relationships relevant to this publication.
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Cited by (51)
Impact of fellow participation on colon adenoma detection rates: a multicenter randomized trial
2020, Gastrointestinal EndoscopyImpact of a simulation-based ergonomics training curriculum on work-related musculoskeletal injury risk in colonoscopy
2020, Gastrointestinal EndoscopyDoes one-man method better than two-man method for colonoscopy insertion in children
2019, Journal of the Formosan Medical AssociationComputerized feedback during colonoscopy training leads to improved performance: a randomized trial
2018, Gastrointestinal EndoscopyCitation Excerpt :The similarities of the difficult case and the final case might have favored participants spending the most time practicing on the difficult case, but this was not apparent in our data analysis. When introducing automatic feedback systems it is important to acknowledge that it is necessary to master more than just the technical skills to be competent in colonoscopy.27 An important limitation is that we did not test transferability to the clinical world, and our data are limited by the lack of validated metrics for the clinical setting.
Impact of fellowship training level on colonoscopy quality and efficiency metrics
2018, Gastrointestinal EndoscopyCitation Excerpt :Adenoma and polyp management efficiency indices (average time required per adenoma and polyp resected, respectively) may be more useful tools to track trainee progress during colonoscopy training. The 2012 American Society for Gastrointestinal Endoscopy colonoscopy core curriculum discusses the lack of well-defined tools to measure competence and hence thresholds for conditional independence.17 This is also reflected in the Accreditation Council for Graduate Medical Education program requirements in Gastroenterology that does not provide concrete measures for determining when trainees are ready for graduated levels of supervision.27
A prospective comparison of live and video-based assessments of colonoscopy performance
2018, Gastrointestinal EndoscopyCitation Excerpt :Participants were adult gastroenterology and general surgical residents, fellows, and attending physicians from 5 hospitals. Purposive sampling was used to recruit novice, intermediate, and experienced endoscopists using pre-specified procedure volume criteria, which were based on present credentialing guidelines and a literature review of colonoscopic competence.1,26-28 Novice endoscopists were defined as individuals who had performed <50 previous colonoscopies.
This document is a product of the ASGE Training Committee. This document was reviewed and approved by the Governing Board of the ASGE.