Abstract
Background
There is a paucity of literature evaluating competence in advanced endoscopic modalities in the treatment of pancreatobiliary diseases. Traditionally, competency in endoscopy has been measured by procedural volume and adverse events. A formal curriculum has not been widely established to standardize proficiency in ERCP. It is clear, from both training and patient quality perspectives that defined outcomes for clinical competence at the conclusion of advanced endoscopic training needs to be established.
Aims
We propose to develop a competency tool for ERCP using a standardized Delphi Approach.
Methods
Delphi Panel Recruitment and Sample:
Delphi methodology will be used to reach consensus amongst a panel of recruited international therapeutic endoscopy experts (Therapeutic Endoscopists, Surgeons, Endoscopy Nurses) to establish criteria for assessing ERCP competence.
Item Generation and Finalization of ERCP Competency Assessment Tool:
Systematic Literature review (ERCP Performance and Assessment) followed by open-ended survey of panel members with opportunity for expert panelist commentary and input. Structure surveys distributed according to Dilman’s tailored design method.
Results: Initial Round
a) Respondents identify the importance of each checklist and global rating item using an ordinal scale. b) Respondents asked to list up to 10-additional checklist or global rating items not included they deeme to be important.
Checklist Items (Figure 2)
Divided into Pre-Procedure, Intra-Procedure and Post-Procedure domains. Procedure competency is further subdivided into Technical, Cognitive and Global Rating domains.
Analysis of Responses
Descriptive statistics to establish mean rating with a 95% confidence interval within each category of ordinal scoring. Checklist or global item to be removed if mean rating < 4.0 and critical rating <5.0. Consensus to be established if homogeneity of opinion seen in 80% or more of respondents in any Delphi round following the introductory round.
Conclusions
No research to date has used trained raters using specifically designed assessment tools with direct observation or video recorded assessments. Rigorous continued assessment of a trainee’s performance with a validated assessment tool is valuable, providing insight to individual learning curves in comparison to other learners in a standardized fashion. Delphi panel results to be complete by CDDW/GRIT.
Funding Agencies
CAG