Assessing Competency and Training of Upper Endoscopy in a General Surgery Residency Program

Willam F. Powers IV, W. Borden Hooks III, S. Nicole Kilbourne, Thomas V. Clancy, William W. Hope


Background: Guidelines for optimal endoscopic training for surgical residents have not been formally integrated into modern teaching programs. Our purpose was to apply two endoscopic evaluation tools (EE-1 and EE-2) designed to measure surgical resident competency in the performance of esophagogastroduodenoscopy (EGD).

Methods: Prospectively collected data were reviewed from consecutive EGDs in a single institution by a single attending surgeon over 3 years (July 2008 to July 2011). Demographic, procedural, and outcome data were collected. Residents were graded at the completion of each procedure by the attending surgeon using EE-1 and EE-2. Descriptive statistics were calculated, and comparisons based on PGY levels were made using Fishers exact and Kruskal-Wallis tests. P < 0.05 was considered significant.

Results: All procedures (N = 50) were performed by residents under the direct attending surgeon supervision. Average patient age was 51 years (range, 31-79 years), 66% were women, and 66% were Caucasian. PGY-3 residents performed 62% of the procedures. Average resident participation was 84% of each procedure. Biopsies were performed in 80% of patients and dilatations in 16%. All EGDs were successfully completed (average time, 13.1 min). EE-1 results demonstrated significantly different grades (P < 0.05) among PGY levels in seven of eight variables. EE-2 grades were significantly different (P < 0.05) among PGY levels in all 10 variables with a general trend of improvement as PGY level increased. There were no mortalities or morbidities.

Conclusions: Residents can perform EGDs safely and expeditiously with appropriate supervision. Methods to assess competency continue to evolve and should remain an area of active research.



Endoscopy; Education; Curriculum

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Gastroenterology Research, bimonthly, ISSN 1918-2805 (print), 1918-2813 (online), published by Elmer Press Inc.                     
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