Rankin, M, Hambleton, S, Derbyshire, E, O'Toole, P and Smith, G (2024) Assessing the state of polypectomy practice: are we ready for the new colonoscopy training pathway? Frontline Gastroenterology. ISSN 2041-4137

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Abstract

Objective The 2023 Joint Advisory Group on Gastrointestinal Endoscopy consensus statements on colonoscopy training and certification in the UK recommend that trainees should be competent in size, morphology, site, access (SMSA) level 2 polypectomy; familiar with classification systems for describing polyps and able to handle common intraprocedural complications. Anecdotal concerns expressed by established colonoscopists regarding their own competence in relation to these new requirements prompted an assessment of the competence and confidence of the existing colonoscopy workforce. Method An anonymous online survey was used to ascertain self-reported competence and confidence in polypectomy among colonoscopists from all professional groups: both medically qualified endoscopists (MEs) (from a medical or surgical background) and clinical endoscopists (CEs), who are nurses or allied health professionals trained to perform independent colonoscopy. Respondents were predominantly from Northwest England. The survey ran between May and August 2023. Attempts were made to identify barriers preventing more advanced practice. Results 120 independent colonoscopists responded (55% medical, 45% clinical). 21% of respondents were confident tackling lesions at SMSA level 4. However, 20% do not remove non-pedunculated lesions >9 mm. The majority of these were CEs. Of those involved in training or supervision, 11% restricted their polypectomy practice to Level 1. Overall, 21% expressed only ‘slight’ or ‘no confidence’ in teaching the SMSA scoring system. CEs involved in training were at least as confident as MEs in teaching aspects of polyp assessment. Lack of support in the event of a complication was of significantly more concern to CEs than MEs (p<0.001). Conclusion The new curriculum presents a technical challenge for only a small minority of established colonoscopists, but we have identified a lack of confidence in teaching about optical diagnosis and the SMSA scoring system. Endoscopy training academies may have a role in educating training supervisors in their region rather than focusing solely on trainees.

Item Type:	Article
Additional Information:	This article has been accepted for publication in [Frontline Gastroenterology, 2024] following peer review, and the Version of Record can be accessed online at https://doi.org/10.1136/flgastro-2024-102814
Subjects:	R Medicine > RD Surgery
Divisions:	Nursing and Advanced Practice
Publisher:	BMJ Publishing Group
SWORD Depositor:	A Symplectic
Date Deposited:	11 Dec 2024 11:26
Last Modified:	11 Dec 2024 11:30
DOI or ID number:	10.1136/flgastro-2024-102814
URI:	https://researchonline.ljmu.ac.uk/id/eprint/25068

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