Endoscopy Working Group
Membership of Group
Dr Mike Thomson
Dr Bruce McLean
Dr Huw Jenkins
Dr Mark Beattie
Dr Richard Russell
Mr Simon Huddart
Dr Stephen Murphy
Dr Muftah Eltumi
Report for 2005
The main focus of this year's ongoing activities has been the analysis of the need for standards of ongoing training, and the potential acquisition of a final CCST in Paediatric Endoscopy. The latter would rely upon trainer assessment of competency, log book completion, and attendance at hands-on and other endoscopy-specific Courses. The former will follow a model devised by the BSG looking at the periodic assessment of the competence, both technical and lesion recognition, of those already trained - this would be based around a so-called 'driving test' and would involve peer-assessment. These are obviously contentious issues which will be further elucidated in 2006/7, but it appears that there is really no escape from this in the medium to long-term. The last issue is that of devising a web-based lesion-recognition tool specific to paediatric GI which in turn may form part of the final assessment for Endoscopy CCST, and possibly in the future for ongoing skill assessment.
Further meetings will be held with all areas of endoscopists in children in the GI sphere represented, and guidance will be sort from the Joint Advisory Group (JAG) on endoscopic training on patient journeys, 360 degree unit appraisal, and other important areas. CSAC visits will continue and will have an integral endscopic training arm which will be assessed for each vistied centre.
Comments or questions on any of these points may be directed to Dr Mike Thomson and will receive attention from the whole group.
Jan 2006
Endoscopy training Courses
All endoscopy courses will be advertised on the meetings page.
Recommendations for Training in Paediatric Endoscopy
It is suggested that the pre-requisites for training and experience required for Paediatric Endoscopy could fall into three broad areas:
1. Facilities
Training in Paediatric Gastroenterology must take place in units recognized by the College Speciality Advisory Committee on Paediatric Gastroenterology.
The training unit should be equipped with modern video endoscopy equipment suitable for use in paediatric practice. High quality tele-visual display and image recording facilities should be mandatory. Access to training videos and 'JPEG/MPEG' programmes on the BSPGHAN web pages will be made available.
2. Endoscopic Experience
1. Published and prospective data from one teaching unit in the UK suggest that most trainees require in the order of 100 diagnostic upper gastrointestinal endoscopies and 100 diagnostic ileo-colonoscopies under supervision before the minimum of acceptable competency is achieved. Specific competence in safety, technical ability, and lesion recognition will be assessed by the designated trainer. Accent is on ongoing skill assessment, i.e. qualitative rather than quantitative.
2. Initial technical experience in handling the endoscope/colonoscope may be gained in adult training environments, but these procedures will not be entered into the paediatric endoscopy logbook.
3. Trainees should have experience of removal of foreign bodies at upper gastrointestinal endoscopy and polypectomy at colonoscopy.
4. After achieving competence at these procedures (Level 1) it is expected that higher level training, if required, will provide experience in and competence to perform a wide variety of therapeutic procedures (Level 2). Threshold numbers of procedures would include, for instance: 5 variceal haemostasis procedures; 10 oesophageal dilations; 5 percutaneous gastrostomies - however the number performed does of course not equate with competence. Accent is on ongoing skill assessment, i.e. qualitative rather than quantitative.
A written record of the number and variety of procedures carried out under supervision, and subsequently independently, should be kept for the trainee's 'procedure experience record' or 'logbook'.
3. Courses in diagnostic and therapeutic paediatric endoscopy
1. Trainees should endeavour to attend courses in both diagnostic and therapeutic endoscopy.
2. Courses should be approved by the BSPGHAN CSAC and be provided on a regional or national basis.
Basic courses covering the principles of endoscopic practice may also be attended. These might be run purely for paediatric trainees, or in conjunction with the Basic Theory
Endoscopy training Log Books can be downloaded: Logbook | Summary Logbook
Guidelines for Training in Paediatric Endoscopy and Colonoscoy in the United Kingdom
This discussion document can be downloaded: Word | Acrobat
Copyright © 2006 British Society of Paediatric Gastroenterology Hepatology and Nutrition