TABLE 3.
Adherence rate to European Society of Gastrointestinal Endoscopy (ESGE) Recommendations on Endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic ultrasound (EUS) Training.
| Number of ESGE recommendation | Number positive answers | Number negative answers | % Adherence to the recommendation |
|---|---|---|---|
| 1. Every endoscopist should have achieved competence in UGI endoscopy before commencing training in ERCP or EUS, that is, having personal experience of at least 300 gastroscopies and meeting the ESGE quality measures for UGI endoscopy | 24 | 6 | 80% |
| 2a. Simulation‐based training represents a positive development to accelerate the trainee's learning curve and should be encouraged. | 21 | 20 | 51.2% |
| 2b. When available, trainees should start training by undertaking structured supervised ERCP/EUS simulator‐based training before commencing hands‐on training in the workplace | 9 | 12 | 42.9% |
| 3. Where it is available, simulation‐based training should evolve in a stepwise approach for training: Virtual reality and mechanical simulators should be used during early training, followed by hands‐on endoscopy training | |||
| 4, 5. Trainees should undertake formal courses to complement ERCP/EUS training. ERCP and EUS trainees should engage with a range of learning resources to supplement formal courses and experiential learning. | 15 | 21 | 41.7% |
| 6. ERCP and EUS training should follow a structured syllabus to guide what is covered in workplace learning, formal training courses, and self‐directed study | 22 | 19 | 53.7% |
| 7. A minimum training period of 12 months of high volume training is likely to be required to obtain minimum proficiency in both ERCP and diagnostic EUS. | 22 | 19 | 53.7% |
| 8. A significant proportion of training should be based in high volume a training centers that are able to offer trainees a sufficient wealth of experience for at least 12 months: | |||
| 8a. ERCP | 39 | 2 | 95.1% |
| 8b. EUS | 37 | 4 | 90.2% |
| 9. An ERCP/EUS training center should ideally be able to provide: | |||
| 9a. Multidisciplinary hepatobiliopancreatic meetings | 37 | 4 | 90.2% |
| 9b. Onsite hepaticopancreaticobiliary surgery | 37 | 4 | 90.2% |
| 9c. Onsite interventional radiology | 39 | 2 | 95.1% |
| 9d. ERCP and EUS simulation | 21 | 20 | 51.2% |
| 9e. Involvement in research, service improvement initiatives | 36 | 5 | 87.8% |
| 10, 11. A trainee's principal trainer should ideally have more than 3 years' experience of independent ERCP and/or EUS practice. | 33 | 8 | 80.5% |
| 13. Formal assessments tools should be used regularly during ERCP and EUS training to track the acquisition of trainees' competence and to support trainee feedback | 12 | 19 | 44.4% |
| 14. Trainees should be encouraged to undertake self‐assessment and keep a contemporaneous logbook of all cases, which includes the degree of trainer support that was needed for each aspect of the procedure | 9 | 12 | 42.9% |
| 15. A trainee should undergo: | |||
| 15a. Formal summative assessment process | 27 | 14 | 65.9% |
| 15b. Prior commencing independent practice in ERCP/EUS | 8 | 33 | 38.1% |
| 20, 28. The number of ERCP/EUS performed may be a surrogate marker of competence, but in isolation is an inexact means to demonstrate competence. Most trainees are likely to need to have performed >300 ERCPs/> 250 diagnostic EUSs to be in a position to demonstrate competency | 1 | 24 | 4% |
Abbreviation: UGI, Upper gastrointestinal.
a
High‐volume training centers defined as performing >300 EUS/ERCPs per year.