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Determining Endoscopic Competency by Contrasting Endoscopic Experience, GAGES and BEST Box Scores

Ilay Habaz, Bsc1, Allan Okrainec, Dr1, Ethan Weiss1, Silvana Perretta, Dr2, Else V Velden2, Ludovica Guerriero2, Fabio Longo2, Pietro Mascagni2, Louis Liu, Dr3, Timothy Jackson, Dr1, Lee L Swanstorm, Dr4, Eran Shlomovitz, Dr1. 1University Health Network, Department of General Surgery, 2IHU-Strasbourg, Strasbourg, France, 3University Health Network, Department of Gastroenterology, 4The Oregon Clinic, Division of GI/MIS, Portland, OR, USA

Introduction: To investigate the relationship between the Basic Endoscopic Skills Training (BEST) Box, Global Assessment of Gastrointestinal and Endoscopic Skills (GAGES) rating tool and number of endoscopic procedures performed to evaluate the relationship between number of endoscopic procedures performed and endoscopic competency.

Methods: A total of 55 participants were tested. Participants were scored on the BEST box by a trained proctor using an objective scoring formula which rewards speed and accuracy. GAGES scores were separately evaluated by a trained administrator. “Ability to keep clear view” was removed, as this is a skill that BEST box does not simulate, thus the passing score on GAGES was set at 15/20. Prior endoscopic experience was assessed using a pre-test questioner to gauge number of endoscopic cases performed. For the analysis, participants were placed subgroups according to procedure numbers (Table 1). Due to a small sample size (n=1), the ‘101-200 cases’ group was excluded.

Results: A significant positive correlation was observed between user experience, BEST box score and GAGES score (Table 1). The >200 endoscopy group had the highest GAGES pass rate at 90%, this is statistically significantly better as compared to users who performed ≤ 100 procedures (p < .001). The ‘>200’ also had the highest BEST box score mean and pass rate (M=83.5, p<.001) compared to groups with ≤ 100 procedures (M=60.43).

Conclusion: Due to inconsistent sample sizes and variability within each group the ability to detect a linear progression of experience among groups was not possible. However, there is enough evidence to suggest that individuals with less than 100 endoscopy procedures have insufficient endoscopic skills. Additionally, the results suggest that BEST box may be an objective assessment tool to assess user competency. Further investigation is required to determine if a higher threshold should be recommended.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 91705

Program Number: P380

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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