Abstract
Background and study aims Operator competency is essential for esophagogastroduodenoscopy (EGD) quality, which
makes appropriate training with a final test important. The aims of this study were
to develop a test for assessing skills in performing EGD, gather validity evidence
for the test, and establish a credible pass/fail score.
Methods An expert panel developed a practical test using the Simbionix GI Mentor II simulator
(3 D Systems) and an EGD phantom (OGI 4, CLA Medical) with a diagnostic (DP) and a
technical skills part (TSP) for a prospective validation study. During the test a
supervisor measured: 1) total time; 2) degree of mucosal visualization; and 3) landmarks
and pathology identification. The contrasting groups standard setting method was used
to establish a pass/fail score.
Results We included 15 novices (N), 10 intermediates (I), and 10 experienced endoscopists
(E). The internal structure was high with a Cronbach’s alpha of 0.76 for TSP time
consumption and 0.74 for the identification of landmarks.
Mean total times, in minutes, for the DP were N 15.7, I 11.3, and E 7.0, and for TSP.,
they were N 7.9, I 8.9, and E 2.9. The total numbers of identified landmarks were
N 26, I 41, and E 48. Mean visualization percentages were N 80, I 71, and E 71. A
pass/fail standard was established requiring identification of all landmarks and performance
of the TSP in < 5 minutes. All experienced endoscopists passed, while none of the
endoscopists in the other categories did.
Conclusions We established a test that can distinguish between participants with different competencies.
This enables an objective and evidence-based approach to assessment of competencies
in EGD.
