On Endoscopic Training and Procedural Competence
Authors: John Baillie
Journal: Annals of Internal Medicine (1993)

Editorials1 January 1993On Endoscopic Training and Procedural CompetenceJohn Baillie, MB, ChB and William J. Ravich, MDJohn Baillie, MB, ChBDuke University Medical Center, Durham, NC 27710. The Johns Hopkins Medical Institutions, Baltimore, MD 21205. and William J. Ravich, MDDuke University Medical Center, Durham, NC 27710. The Johns Hopkins Medical Institutions, Baltimore, MD 21205.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-1-199301010-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Physicians are expected to be competent. However, it is difficult to define competence and determine how it can be achieved. This applies particularly to technical procedures in medicine. A study by Cass and colleagues in this issue of Annals suggests that at least 100 supervised procedures are required to achieve competence in esophagogastroduodenoscopy (EGD) and colonoscopy. This experience greatly exceeds the current requirements of national training bodies. How should we evaluate the cognitive aspects of procedural training and ensure that competence, once achieved, is maintained? Prospective evaluation of physician performance, already a concern of quality assurance programs, may provide the ...References1. American Heritage Dictionary. 2d ed. Boston: Houghton Mifflin Co.; 1976. Google Scholar2. Hawes R, Lehman GA, Hast J, O'Connor KW, Crabb DW, Lui A, et al. Training resident physicians in fiberoptic sigmoidoscopy. How many supervised examinations are required to achieve competence? Am J Med. 1986; 80:465-70. Google Scholar3. Standards of Training Committee, American Society for Gastrointestinal Endoscopy. Principles of training in GI endoscopy. Manchester, Massachusetts: American Society for Gastrointestinal Endoscopy 1991:7. Google Scholar4. American Society for Gastrointestinal Endoscopy. 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Cass OW, Freeman MS, Peine CJ, Zera RT, Onstad GR. Objective evaluation of endoscopy skills during training. Ann Intern Med. 1993; 118:40-4. Google Scholar11. Manu P, Lane TJ, Matthews DA. How much practice makes perfect? A quantitative measure of the experience needed to achieve procedural competence. Med Teach. 1990; 12:367-9. Google Scholar12. Jowell PS, Baillie J. Endoscopy teaching, present and future: the impact of videoendoscopy and computer simulation. Gastrointestinal Endoscopy Clinics of North America. 1992; 2:299-311. Google Scholar13. Williams CB, Baillie J, Gillies DF, Borislow D, Cotton PB. Teaching gastrointestinal endoscopy by computer simulation: a prototype for colonoscopy and ERCP. Gastrointest Endosc. 1990; 36:49-54. Google Scholar14. Baillie J, Jowell P, Evangelou H, Bickel W, Cotton P. Use of computer graphics simulation for teaching of flexible sigmoidoscopy. Endoscopy. 1991; 23:126-9. Google Scholar15. Noar MD, Soehendra N. Endoscopy simulation training devices. Endoscopy. 1992; 24:159-66. Google Scholar16. Brandt LJ. Training in gastrointestinal endoscopy (Editorial). Gastrointest Endosc. 1992; 38:88-9. Google Scholar17. Sivak MV Jr. Advanced training in gastrointestinal endoscopy (Editorial). Gastrointest Endosc. 1992; 38:90-1. Google Scholar Author, Article, and Disclosure InformationAuthors: John Baillie, MB, ChB; William J. Ravich, MDAffiliations: Duke University Medical Center, Durham, NC 27710. The Johns Hopkins Medical Institutions, Baltimore, MD 21205.Corresponding Author: John Baillie, MB, ChB, Division of Gastroenterology, Duke University Medical Center, Box 3189, Durham, NC 27710. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoObjective Evaluation of Endoscopy Skills during Training Oliver W. Cass , Martin L. Freeman , Craig J. Peine , Richard T. Zera , and Gerald R. 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