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Defining competencies for endoscopic submucosal dissection (ESD) for gastric neoplasms

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Abstract

Background

Current methods for teaching and assessing competencies for endoscopic submucosal dissection (ESD) are highly variable, non-systematic, and are inefficient for the learner to acquire adequate skills. The present study aims to define and establish expert consensus regarding competencies required to perform ESD for gastric neoplasms.

Methods

Fourteen ESD experts from 12 institutions in Japan were invited to complete an online survey to rate potential items for their importance in performing ESD proficiently. By using methodology based on the Delphi principles, the results of each round were analyzed and re-sent to the experts until consensus was established. Items were included if ranked 8 out of a 10-point Likert scale, by ≥ 80% of the respondents.

Results

A list of 29 potential items was generated through a review of the literature, textbooks, and experience of the steering group members. Ten new items were added through the survey. Consensus was reached after three rounds. Response rate ranged from 93 to 100%. Thirty-four items achieved consensus as important surrogates of competency in performing ESD.

Conclusions

Essential competencies for performing ESD were identified through expert consensus. These competencies can serve as the foundation for structured training and for development of objective assessment tools to evaluate trainee performance in ESD.

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Acknowledgements

The authors would like to thank Dr. M. Endo from Kaiunbashi Endoscopy Clinic, Dr. T. Hikichi from Fukushima Medical University Hospital, Dr. K. Hirasawa from Yokohama City University Medical Center, Dr. H. Machida from Machida Gastrointestinal Hospital, Dr. A. Imagawa from Imagawa Medical Clinic, Dr. K. Takimoto from National Hospital Organization Kyoto Medical Center, Dr. M. Takeuchi from Nagaoka Red Cross Hospital, Dr. K. Yamamoto from Japan Community Health Care Organization Osaka Hospital, Dr. S. Morita from Kobe City Medical Center General Hospital, Dr. Y. Kitamura from Nara City Hospital, and Dr. N. Kakushima from Shizuoka Cancer Center for participating in the survey as the expert panel. We would also like to take this opportunity to thank Dr. Y. Tsuji from the University of Tokyo, Dr. M. Kato from Keio University School of Medicine and Dr. M. Yoshida from Shizuoka Cancer Center for supporting this study in defining the competencies for ESD for gastric neoplasms.

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Authors and Affiliations

  1. Department of Surgery and Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University, D6-136, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada

    Madoka Takao, Elif Bilgic, Pepa Kaneva, Satoshi Endo & Gerald M. Fried

  2. Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan

    Madoka Takao, Yoshiko Nakano, Shinwa Tanaka, Yoshinori Morita, Eiji Umegaki & Yuzo Kodama

  3. Division of Gastroenterology, McGill University, Montreal, QC, Canada

    Kevin Waschke

  4. Department of Endoscopy, Kobe University Hospital, Kobe, Hyogo, Japan

    Takashi Toyonaga

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  1. Madoka Takao
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  2. Elif Bilgic
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  4. Pepa Kaneva
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Correspondence to Gerald M. Fried.

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Disclosures

Drs. Madoka Takao, Elif Bilgic, Kevin Waschke, Pepa Kaneva, Satoshi Endo, Yoshiko Nakano, Shinwa Tanaka, Yoshinori Morita, Takashi Toyonaga, Eiji Umegaki, Yuzo Kodama, and Gerald M. Fried have no conflicts of interest or financial ties to disclose.

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Takao, M., Bilgic, E., Waschke, K. et al. Defining competencies for endoscopic submucosal dissection (ESD) for gastric neoplasms. Surg Endosc 33, 1206–1215 (2019). https://doi.org/10.1007/s00464-018-6397-4

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  • DOI: https://doi.org/10.1007/s00464-018-6397-4

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