A standardized technique for gastroscopy: Still missing?

The effectiveness of esophagogastroduodenoscopy (EGD) for diagnosis and management of upper gastrointestinal disorders is dependent on operator skill. Endoscopic training focuses on not only the technical skills needed for endoscope manipulation, but also cognitive skills, such as lesion identification, and non-technical skills, such as communication and teamwork [1]. Novice endoscopists encounter a prolonged learning curve, as they need to master all three skill domains to provide safe, high-quality endoscopic care [2] [3]. Despite EGD being a commonly performed procedure even taught to primary care physicians [4], there is no standardized technique or curriculum.

Publication History

Article published online:
21 September 2020

• References

• 1 Walsh CM. In-training gastrointestinal endoscopy competency assessment tools: types of tools, validation and impact. Best Practice Res Clin Gastroenterol 2016; 30: 357-374
• 2 Miller AT, Sedlack RE. Competency in esophagogastroduodenoscopy: a validated tool for assessment and generalizable benchmarks for gastroenterology fellows. Gastrointest Endosc 2019; 90: 613
• 3 Han S, Obuch JC, Duloy AM. et al. A prospective multicenter study evaluating endoscopy competence among gastroenterology trainees in the era of the next accreditation system. Academic Med 2020; 95: 283-292
• 4 Thomas J, Bredfeldt R, Easterling G. et al. Esophagogastroduodenoscopy training in family practice residency program. Family Med 1997; 29: 572-574
• 5 Siau K, Crossley J, Dunckley P. et al. Direct observation of procedural skills (DOPS) assessment in diagnostic gastroscopy: nationwide evidence of validity and competency development during training. Surg Endosc 2020; 34: 105-114
• 6 Lee S-H, Park Y-K, Cho S-M. et al. Technical skills and training of upper gastrointestinal endoscopy for new beginners. World J Gastroenterol 2015; 21: 759
• 7 Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med 2004; 79: S70-S81
• 8 Sugimoto K, Osawa S. "Four-position method" makes beginner endoscopists aware of spatial positioning of the left hand to master upper gastrointestinal endoscopy. Endosc Int Open 2020; 08: E1225-E1230
• 9 Khan R, Plahouras J, Johnston BC. et al. Virtual reality simulation training for health professions trainees in gastrointestinal endoscopy. Cochrane Database Syst Rev 2018; 8: CD008237
• 10 Khan R, Plahouras J, Johnston BC. et al. Virtual reality simulation training in endoscopy: a Cochrane review and meta-analysis. Endoscopy 2019; 51: 653-664
• 11 Van Merrienboer JJG, Sweller J. Cognitive load theory in health professional education: design principles and strategies: Cognitive load theory. Med Ed 2010; 44: 85-93
• 12 Grover SC, Scaffidi MA, Khan R. et al. Progressive learning in endoscopy simulation training improves clinical performance: a blinded randomized trial. Gastrointest Endosc 2017; 86: 881-889
• 13 Scaffidi M, Walsh CM, Khan R. et al. Influence of video-based feedback on self-assessment accuracy of endoscopic skills: a randomized controlled trial. Endosc Int Open 2019; 7: E678-E684
• 14 Walsh CM, Scaffidi MA, Khan R. et al. Non-technical skills curriculum incorporating simulation-based training improves performance in colonoscopy among novice endoscopists: Randomized controlled trial. Dig Endosc 2020; [published online ahead of print, 2020 Jan 7]
• 15 Park J, MacRae H, Musselman LJ. et al. Randomized controlled trial of virtual reality simulator training: transfer to live patients. Am J Surg 2007; 194: 205-211
• 16 Sedlack RE, Baron TH, Downing SM. et al. Validation of a colonoscopy simulation model for skills assessment. Am J Gastroenterol 2007; 102: 64-74
• 17 Khan R, Scaffidi MA, Satchwell J. et al. Impact of a simulation-based ergonomic training curriculum on work-related musculoskeletal injury risk in colonoscopy. Gastrointest Endosc 2020;