Training in basic gastrointestinal endoscopic procedures: a European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement

Giulio Antonelli; Andrei M. Voiosu; Katarzyna M. Pawlak; Tiago Cúrdia Gonçalves; Nha Le; Michiel Bronswijk; Marcus Hollenbach; Omar Elshaarawy; Ulrike Beilenhoff; Pietro Mascagni; Theodor Voiosu; Maria Pellisé; Mário Dinis-Ribeiro; Konstantinos Triantafyllou; Marianna Arvanitakis; Raf Bisschops; Cesare Hassan; Helmut Messmann; Ian M. Gralnek

doi:10.1055/a-2205-2613

Endoscopy, Table of Contents

Endoscopy 2024; 56(02): 131-150
DOI: 10.1055/a-2205-2613

Position Statement

Training in basic gastrointestinal endoscopic procedures: a European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement

Giulio Antonelli ‡^‡

¹Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, "Sapienza" University of Rome, Italy

²Gastroenterology and Digestive Endoscopy Unit, Ospedale dei Castelli Hospital, Ariccia, Rome, Italy

,

Andrei M. Voiosu ‡^‡

³Department of Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania

⁴“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

,

Katarzyna M. Pawlak

⁵Endoscopy Unit, Gastroenterology Department, Hospital of the Ministry of Interior and Administration, Szczecin, Poland

⁶The Center for Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, University of Toronto, Ontario, Canada

,

Tiago Cúrdia Gonçalves

⁷Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal

⁸Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal

,

Nha Le

⁹Gastroenterology Division, Internal Medicine and Hematology Department, Semmelweis University, Budapest, Hungary

,

Michiel Bronswijk

¹⁰Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Belgium

¹¹Department of Gastroenterology and Hepatology, Imelda General Hospital, Bonheiden, Belgium

,

Marcus Hollenbach

¹²Division of Gastroenterology, Medical Department II, University of Leipzig Medical Center, Leipzig, Germany

,

Omar Elshaarawy

¹³Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Menoufia, Egypt

,

Ulrike Beilenhoff

¹⁴ESGENA Scientific Secretary, Ulm, Germany

,

Pietro Mascagni

¹⁵IHU Strasbourg, Strasbourg, France

¹⁶Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

,

Theodor Voiosu

³Department of Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania

⁴“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

,

Maria Pellisé

¹⁷Department of Gastroenterology, Hospital Clínic Barcelona, Barcelona, Spain

,

Mário Dinis-Ribeiro

¹⁸Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal

¹⁹MEDCIDS/Faculty of Medicine, University of Porto, Porto, Portugal

,

Konstantinos Triantafyllou

²⁰Gastroenterology Department, Attikon University Hospital, Chaidari, Greece

,

Marianna Arvanitakis

²¹Department of Gastroenterology and Hepatology, University Hospitals Leuven, TARGID, Leuven, Belgium

,

Raf Bisschops

²¹Department of Gastroenterology and Hepatology, University Hospitals Leuven, TARGID, Leuven, Belgium

,

Cesare Hassan

²²Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy

²³Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy

,

Helmut Messmann

²⁴Department of Gastroenterology, Faculty of Medicine, University of Augsburg, Augsburg, Germany

,

Ian M. Gralnek

²⁵Institute of Gastroenterology and Hepatology, Emek Medical Center, Afula, Israel

²⁶Rappaport Faculty of Medicine Technion Israel Institute of Technology, Haifa, Israel

› Author Affiliations

Abstract

Main Statements

This ESGE Position Statement provides structured and evidence-based guidance on the essential requirements and processes involved in training in basic gastrointestinal (GI) endoscopic procedures. The document outlines definitions; competencies required, and means to their assessment and maintenance; the structure and requirements of training programs; patient safety and medicolegal issues.

1 ESGE and ESGENA define basic endoscopic procedures as those procedures that are commonly indicated, generally accessible, and expected to be mastered (technically and cognitively) by the end of any core training program in gastrointestinal endoscopy.

2 ESGE and ESGENA consider the following as basic endoscopic procedures: diagnostic upper and lower GI endoscopy, as well as a limited range of interventions such as: tissue acquisition via cold biopsy forceps, polypectomy for lesions ≤ 10 mm, hemostasis techniques, enteral feeding tube placement, foreign body retrieval, dilation of simple esophageal strictures, and India ink tattooing of lesion location.

3 ESGE and ESGENA recommend that training in GI endoscopy should be subject to stringent formal requirements that ensure all ESGE key performance indicators (KPIs) are met.

4 Training in basic endoscopic procedures is a complex process and includes the development and acquisition of cognitive, technical/motor, and integrative skills. Therefore, ESGE and ESGENA recommend the use of validated tools to track the development of skills and assess competence.

5 ESGE and ESGENA recommend incorporating a multimodal approach to evaluating competence in basic GI endoscopic procedures, including procedural thresholds and the measurement and documentation of established ESGE KPIs.

7 ESGE and ESGENA recommend the continuous monitoring of ESGE KPIs during GI endoscopy training to ensure the trainee’s maintenance of competence.

9 ESGE and ESGENA recommend that GI endoscopy training units fulfil the ESGE KPIs for endoscopy units and, furthermore, be capable of providing the dedicated personnel, infrastructure, and sufficient case volume required for successful training within a structured training program.

10 ESGE and ESGENA recommend that trainers in basic GI endoscopic procedures should be endoscopists with formal educational training in the teaching of endoscopy, which allows them to successfully and safely teach trainees.

Full Text

References

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