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Background: Inflammatory bowel disease (IBD) is a chronic relapsing disease that requires evaluation using multiple objective tools. In Europe, bowel ultrasound (US) is a widely accepted modality used for the management of patients with IBD; however, its use in North America has only recently emerged as a potential technique. Objectives: Our goal was to identify current practice patterns of pediatric gastroenterologists and radiologists using bowel US in patients with IBD and highlight perceived limitations to the widespread adoption of this modality in North America. Methods: A 14-question survey was e-mailed to the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition internet bulletin board composed of 3,058 subscribers from 51 countries; the Society of Pediatric Radiology listserv composed of 1,917 subscribers worldwide; and the Society of Chairs of Radiology at Children's Hospitals listserv. Descriptive summary statistics was used. Results: In North America, about one-quarter of gastroenterology and radiology participants reported using bowel US for IBD; over 3-fourths expressed an interest in using US more often. Bowel US was performed more frequently for Crohn's disease. Both groups agreed the main limitation to using bowel US was concern for inter-observer variability and operator-dependent factors; radiologists reported that other modalities are more effective to assess IBD, whereas gastroenterologists reported unfamiliarity with bowel US indications and techniques. Conclusions: Our data show there is significant interest among both radiologists and gastroenterologists in using bowel US. However, lack of education, insufficient training, and perceived high inter-observer variability among US technologists are limitations preventing the widespread adoption of US for IBD in North America.

Background: Endoscopy is a fundamental skill learned during a paediatric gastroenterology fellowship. The aim of this study was to determine the number of procedures performed during fellowship and to evaluate a trainee's self-perceived competency of their endoscopic skills. Methods:A survey link was emailed to the NASPGHAN PEDI GI Fellows listserv composed of 372 fellows. Procedural count of eight routine procedures and a visual analogue scale measuring fellow's self-perceived competency for each procedure were evaluated. The data were collected and stored using REDCap. Data analysis was completed using descriptive statistics. Results: One hundred and sixty-seven fellows (45%) completed the survey: 28% first year, 41% second year and 31% third year. 50% or fewer of third-year fellows felt competent and met the complete procedural number thresholds recommended by the 2013 NASPGHAN training guidelines for routine procedures except for diagnostic oesophagogastroduodenoscopy (EGD). Subjects felt competent regarding colonoscopy but only 24% reached the threshold. There was no difference in EGD counts between small vs large training programmes (P = .51). Therapeutic endoscopy scored the lowest on self-reported competency scale. Conclusion: This study showed that a majority of third-year trainees feel competent regarding EGD and colonoscopy skills, but only reached threshold counts in EGD. Although paediatric gastroenterologists and trainees are thought to perform safe and effective gastrointestinal endoscopy, this data suggest that time could be dedicated to more complex procedural training. Additional research should be completed in this area to evaluate the value of self-reported competency and to consider revision of the 2013 NASPGHAN training guidelines. How to cite this article: Gamboa HE, Friedlander JA. Paediatric gastroenterology fellows' self-assessment of endoscopy skills.