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Competency assessment for gastric endoscopic submucosal dissection using an endoscopic part-task training box

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Abstract

Background

Objective assessment of endoscopist competency is important. Recently, the endoscopic part-task training box (Thompson Endoscopic Skills Trainer [TEST]) was developed to assess endoscopist competency. We aimed to evaluate the ability of the TEST to assess competency during endoscopic procedures, especially endoscopic submucosal dissection (ESD).

Methods

Twenty-three physicians were included in this study. Correlations between TEST scores and the following factors were evaluated: years of endoscopic experience, number of esophagogastroduodenoscopies (EGDs) performed, number of colonoscopies (CSs) performed, cecal intubation rate, number of gastric ESDs performed, gastric ESD procedure time/lesion size (min/mm2), and gastric ESD self-completion rate. Also, correlation coefficients between the number of gastric ESDs performed and each of gastric ESD procedure time/lesion size and gastric ESD self-completion rate were calculated.

Results

TEST scores showed strong correlations to different factors: years of experience in endoscopy: 0.957 (p < 0.01); number of EGDs: 0.947 (p < 0.01); number of CSs: 0.947, (p < 0.01); number of gastric ESDs: 0.924 (p < 0.01); gastric ESD procedure time/lesion size: − 0.9 (p < 0.01); self-completion rate of gastric ESDs: 0.857 (p < 0.005). The number of gastric ESDs performed was not more strongly correlated to procedure time of gastric ESDs or self-completion rate of gastric ESDs compared to TEST scores (− 0.824 (p < 0.01) and 0.704 (p < 0.05), respectively). TEST scores of endoscopists with a cecal intubation rate ≥ 90% were > 380, while the scores of physicians with a gastric ESD self-completion rate ≥ 90% were > 700.

Conclusions

TEST score correlates with both basic and advanced endoscopic procedures. TEST is therefore a promising option for assessing endoscopist competency, and might be useful for providing threshold scores as competency markers for specific endoscopic procedures such as gastric ESD.

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Authors and Affiliations

  1. Department of Endoscopy, The Jikei University School of Medicine, 3-25-8 Nishi Shinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Naoto Tamai, Hiroyuki Aihara, Masayuki Kato, Kimio Isshi & Kazuki Sumiyama

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  1. Naoto Tamai
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  2. Hiroyuki Aihara
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  3. Masayuki Kato
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  4. Kimio Isshi
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  5. Kazuki Sumiyama
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Contributions

NT: conception and design; analysis and interpretation of the data; drafting of the article. HA: conception and design; critical revision of the article for important intellectual content. MK: conception and design. KI: conception and design. KS: conception and design.

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Correspondence to Naoto Tamai.

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Disclosures

Naoto Tamai, Hiroyuki Aihara, Masayuki Kato, Kimio Isshi, and Kazuki Sumiyama have no conflicts of interest or financial ties to disclose.

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Tamai, N., Aihara, H., Kato, M. et al. Competency assessment for gastric endoscopic submucosal dissection using an endoscopic part-task training box. Surg Endosc 33, 2548–2552 (2019). https://doi.org/10.1007/s00464-018-6548-7

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