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Development and validation of a novel method for assessing competency in polypectomy: direct observation of polypectomy skills - 11/08/11

Doi : 10.1016/j.gie.2011.01.069 
Sachin Gupta, MRCP a, , John Anderson, MD b, Pradeep Bhandari, MD c, Brian McKaig, MD d, Pullan Rupert, MD e, Bjorn Rembacken, MD f, Stuart Riley, MD g, Matt Rutter, MD h, Roland Valori, MD b, Margaret Vance, MSc a, Cees P.M. van der Vleuten, PhD i, Brian P. Saunders, MD a, Siwan Thomas-Gibson, MD a
a Wolfson Unit for Endoscopy, St. Mark's Hospital and Imperial College London HA1 3UJ., United Kingdom 
b Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom 
c Portsmouth Hospitals NHS Trust, United Kingdom 
d New Cross Hospital, Wolverhampton, United Kingdom 
e South Devon Healthcare NHS Foundation Trust, Torbay District General Hospital, Torquay, United Kingdom 
f Leeds Teaching Hospitals NHS Trust, St. James's University Hospital, Leeds, United Kingdom 
g Northern General Hospital, Sheffield, United Kingdom 
h University Hospital of North Tees, Stockton-on-Tees, United Kingdom 
i Department of Educational Development and Research, University of Maastricht, Maastricht, the Netherlands 

Reprint requests: Sachin Gupta, MBBS, MRCP, Wolfson Unit for Endoscopy, St. Mark's Hospital and Imperial College London, Watford Road, Harrow, UK

Riassunto

Background

Despite its ubiquitous use over the past 4 decades, there is no structured, formal method with which to assess polypectomy.

Objective

To develop and validate a new method with which to assess competency in polypectomy.

Design

Polypectomy underwent task deconstruction, and a structured checklist and global assessment scale were developed (direct observation of polypectomy skills [DOPyS]). Sixty bowel cancer screening polypectomy videos were randomly chosen for analysis and were scored independently by 7 expert assessors by using DOPyS. Each parameter and the global rating were scored from 1 to 4 (scores ≥3 = competency). The scores were analyzed by using generalizability theory (G theory).

Setting

Multicenter.

Results

Fifty-nine of the 60 videos were assessable and scored. The majority of the assessors agreed across the pass/fail divide for the global assessment scale in 58 of 59 (98%) polyps. For G-theory analysis, 47 of the 60 videos were analyzed. G-theory analysis suggested that DOPyS is a reliable assessment tool, provided that it is used by 2 assessors to score 5 polypectomy videos all performed by 1 endoscopist. DOPyS scores obtained in this format would reflect the endoscopist's competence.

Limitations

Small sample and polyp size.

Conclusions

This study is the first attempt to develop and validate a tool designed specifically for the assessment of technical skills in performing polypectomy. G-theory analysis suggests that DOPyS could reliably reflect an endoscopist's competence in performing polypectomy provided a requisite number of assessors and cases were used.

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Abbreviations : BCS, BCSA, BCSP, DOPS, DOPyS, QA, SEM, UK


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 DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.


© 2011  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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