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

BackgroundObjective 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).MethodsTwenty-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/mm(2)), 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.ResultsTEST 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.ConclusionsTEST 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.