Much more practice is needed than gastroenterological professional societies currently recommend, concluded Mayo Clinic researchers in Rochester, Minn.
Current recommendations are that 140 procedures should be done before attempting to assess competency, but with no set recommendations on how to assess it, wrote the author of the research. But it takes an average of 275 procedures for a gastroenterology fellow to reach minimal cognitive and motor competency.
Now, the American Society for Gastrointestinal Endoscopy is rewriting its colonoscopy training guidelines to reflect the need for more procedures and emphasize the use of objective, measurable tests in assessing the competency of trainees.
The study authors assessed the performance of 41 Mayo Clinic gastroenterology fellows who performed more than 6,600 colonoscopies from July 2007 through June 2010. The research team used a validated testing method called the Mayo Colonoscopy Skills Assessment Tool (MCSAT).
The MCSAT assesses areas such as intubation rates and timing, how safely and painlessly practitioners perform the procedure and how clearly the students recognize potential patient issues.
The study's findings may apply to specialties other than gastroenterology, according to a press release from the Mayo Clinic. While gastroenterology fellows may perform well more than 400 colonoscopies during their training, specialists in other areas, such as surgery or family practice, may perform significantly fewer procedures during their training.