To the Editor:
Sedlack et al
1
have highlighted the impact of a new competency assessment tool for colonoscopy. The validated measure encompasses motor and cognitive skills focused on aspects such as scope control, loop reduction, visualization, and pathology identification, to name but a few. They identified typical thresholds for minimal competency and the average number of procedures that will enable a practitioner to be deemed competent.I fully agree with the use of such a tool. However, as yet, we have difficulty determining what factors are relevant in achieving competency. Areas of interest from an educational slant could include, for example, additional pedagogic measures including simulation use, hands-on workshops both locally and abroad, and the adoption of mastery learning styles. For example, in terms of pathology identification, were additional teaching platforms such as videos or online resources used? Was recognition of learning theory adopted; for example, learner autonomy and a sense of relatedness, freedom for learners to explore their own ideas, safeguards to avoid too-rapid a move to gain competency beyond their reasonable limits at a particular time, reflection/feedback in a bidirectional nonjudgemental fashion, measures to deliver training in stages from low to high complexity, creation of a safe learning environment, external peer feedback, and self-directed learning?
Such aspects constitute various recognized learning theory domains, namely, self-determination, cognitive load, and situated cognition.
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Other factors that could implicate competency achievement may include the type of endoscope used, with a focus on other modalities, eg, high-definition, magnification, or narrow-band imaging, and, of course, the use of expert centers, which typically house expert endoscopists.I look forward to determining more the “how” as opposed to the “is.”
Disclosure
The author disclosed no financial relationships relevant to this publication.
References
- Assessment of competency in endoscopy: establishing and validating generalizable competency benchmarks for colonoscopy.Gastrointest Endosc. 2016; 83: 516-523
- Developing the master learner: applying learning theory to the learner, the teacher, and the learning environment.Acad Med. 2013; 88: 1635-1645
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Copyright © 2016 by the American Society for Gastrointestinal Endoscopy
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- Assessment of competency in endoscopy: establishing and validating generalizable competency benchmarks for colonoscopyGastrointestinal EndoscopyVol. 83Issue 3
- PreviewThe Mayo Colonoscopy Skills Assessment Tool (MCSAT) has previously been used to describe learning curves and competency benchmarks for colonoscopy; however, these data were limited to a single training center. The newer Assessment of Competency in Endoscopy (ACE) tool is a refinement of the MCSAT tool put forth by the Training Committee of the American Society for Gastrointestinal Endoscopy, intended to include additional important quality metrics. The goal of this study is to validate the changes made by updating this tool and establish more generalizable and reliable learning curves and competency benchmarks for colonoscopy by examining a larger national cohort of trainees.
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