Definition of minimum procedures required to certify competence in gastrointestinal endoscopy using the Delphi method

Abstract

Introduction: As part of the training framework for medical specialities, it is vital to provide an agreed list of the type and number of practices involved in the professional work of a given specialty. Thus, the purpose of this study is to define a list of minimum procedures to ensure competence in Gastrointestinal Endoscopy based on a structured and agreed upon process, as well as to explore the opinions of experts in gastrointestinal endoscopy on the training of endoscopy physicians in Argentina and the need to certify competencies.Materials and Methods: a mixed-method prospective study was carried out using the Delphi method as a qualitative group research technique, followed by the implementation of a structured survey.Results: The final consolidated list included 17 procedures considered essential for certification of competence in gastrointestinal endoscopy. Median was used given the range in the minimum number of procedures required to achieve competence. In the case of upper gastrointestinal endoscopy, the minimum number of procedures agreed was 200, while in the case of colonoscopy it was 150.Conclusion: This list is a fundamental element to develop a national training framework in gastrointestinal endoscopy, as well as a competence certification program.

Provision of colonoscopy in rural settings: A qualitative assessment of provider context, barriers, facilitators, and capacity

“…Our findings suggest that to ensure access and capacity in rural areas, training opportunities and practice‐level supports should be available for PCPs in colonoscopy 26 . While general surgeons receive training in colonoscopy as part of their residency (typically at a recommended threshold of 50 colonoscopies), training programs generally recommend at least 100–200 procedures for competency, and a high number of completed procedures (275−500) are standard for colonoscopy specialists 66–68 . Prior literature has highlighted this tension between high‐quality colonoscopy procedures and access to screening 26,38,69–72 .…”

“…26 While general surgeons receive training in colonoscopy as part of their residency (typically at a recommended threshold of 50 colonoscopies), training programs generally recommend at least 100-200 procedures for competency, and a high number of completed procedures (275−500) are standard for colonoscopy specialists. [66][67][68] Prior literature has highlighted this tension between high-quality colonoscopy procedures and access to screening. 26,38,[69][70][71][72] While there is conflicting research about quality of colonoscopy services performed by non-GI specialists, research supports the idea that colonoscopy performed by general surgeons and PCPs is safe overall, [34][35][36][37][38] and a recent study concluded screening colonoscopies performed by most physicians in rural and underserved areas met quality standards.…”