James Ansell, Joanna Hurley, James Horwood, Chantelle Rizan, Konstantinos Arnaoutakis, Stuart Goddard, Neil Warren, Jared Torkington
Welsh Institute for Minimal Access Therapy (WIMAT)
Objectives: The aim of this study is to establish if colonoscopists with varying levels of expertise can accurately self-assess their ability to perform colonic polypectomy. An ex-vivo animal polyp simulator previously validated for skills training was used to perform the practical tasks.
Methods and procedures: Ten novices (junior doctors with no experience of endoscopy), 10 Intermediates (Surgical/Gastroenterology registrars), 10 Advanced practitioners (Joint Advisory Group on GI Endoscopy (JAG) accredited colonoscopists) and 10 Experts (JAG bowel screening colonoscopists) each performed a video recorded, standardised polypectomy task on the simulator. This involved snare polypectomy and retrieval of a simple (polyp a) and technically difficult polyp (polyp b). Before the task, all participants self-assessed their ability to perform polypectomy using a Direct Observation of Polypectomy Skills (DOPyS) assessment form. Two independent and blinded, JAG accredited colonoscopists then graded each videoed performance by DOPyS scoring. Self-assessment scores were then compared to assessor’s scores for both polypectomies. Median scores and interquartile ranges (IQR) were compared using a Wilcoxon matched-pair signed-rank test for non-parametric data.
Results:
| Polyp | a | a | a | b | b | b |
| Group | Median (IQR) self assessment DOPyS | Median (IQR) assessors DOPyS | P value | Median (IQR) self assessment DOPyS | Median (IQR) assessors DOPyS | P value |
| N |
0.0 (0.0- 1.0) |
1.0 (0.9-1.6) | 0.019 | 0.0 (0.0- 1.0) | 0.5 (0.4-1.0) | 0.234 |
| I | 2.0 (1.0-2.3) | 2.0 (1.0-2.3) | 0.416 | 2.0 (1.0-2.3) | 1.3 (0.5-2.5) | 0.514 |
| A |
3.0 (3.0-3.0) |
3.0 (2.9-3.5) | 0.416 | 3.0 (3.0-3.0) | 2.8 (2.0-3.5) | 0.478 |
| E | 4.0 (3.0-4.0) | 3.3 (3.0-4.0) | 0.350 | 4.0 (3.0-4.0) |
3.0 (2.5-4.0) |
0.170 |
N=Novice, I=Intermediate, A=Advanced, E=Expert. For DOPyS scores; 4=highly skilled performance, 3=competent performance, 2=some standards are met with some uncorrected errors, 1= accepted standards not met with frequent uncorrected errors, 0=unable to assess.
Conclusion: Colonoscopists of all levels can reliably self-assess their ability to perform a simulated polypectomy using the WIMAT colonoscopy suitcase. This is independent of the level of difficulty of the task. This has potential application for use by endoscopists who are preparing for accreditation or re-validation.
Session: Poster Presentation
Program Number: P143
