title: Training in small-bowel capsule endoscopy: assessing and defining competency.
abstract: BACKGROUND
  Minimum training for capsule endoscopy (CE) is based on societal guidelines and expert opinion. Objective measures of competence are lacking.
  
  
  OBJECTIVE
  Our objectives were to (1) establish structured CE training curriculum during a gastroenterology fellowship, (2) develop a formalized assessment tool to evaluate CE competency, (3) prospectively analyze trainee CE competency, (4) define metrics for trainee CE competence by using comparative data from CE staff, and (5) determine the correlation between CE competence and previous endoscopy experience.
  
  
  METHODS
  Single-center, prospective analysis over 6 years.
  
  
  METHODS
  Tertiary academic center.
  
  
  METHODS
  Gastroenterology fellows and CE staff.
  
  
  METHODS
  Structured CE training was implemented with supervised CE interpretation. Capsule Competency Test (CapCT) was developed and data were collected on the number of CEs, upper endoscopies, colonoscopies, and push enteroscopies performed.
  
  
  METHODS
  Trainee competence defined as CapCT score 90% or higher of the mean staff score.
  
  
  RESULTS
  A total of 39 fellows completed CE training and CapCT. Fellows were grouped according to number of completed CE interpretations: 10 or fewer (n = 13), 11 to 20 (n = 19), and 21 to 35 (n = 7). Eight CE staff completed CapCT with a mean score of 91%. Mean scores for trainees with fewer than 10, 11 to 20, and 21 to 35 CE interpretations were 79%, 79%, and 85%, respectively. A significant difference was seen between staff and fellow scores with 10 or fewer and 11 to 20 interpretations (P < .001). No correlation was found between trainee scores and previous endoscopy experience.
  
  
  CONCLUSIONS
  Single center.
  
  
  CONCLUSIONS
  Using a structured CE training curriculum, we defined competency in CE interpretation by using the CapCT. Based on these findings, trainees should complete more than 20 CE studies before assessing competence, regardless of previous endoscopy experience.
authors.affiliation: Developmental Endoscopy Unit, Mayo Clinic College of Medicine, Rochester, Minnesota, USA; Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rajan
authors.forename: Prasad G
authors.initials: PG
authors.lastname: Iyer
authors.forename: Amy S
authors.initials: AS
authors.lastname: Oxentenko
authors.forename: Darrell S
authors.initials: DS
authors.lastname: Pardi
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Alexander
authors.forename: Todd H
authors.initials: TH
authors.lastname: Baron
authors.forename: David H
authors.initials: DH
authors.lastname: Bruining
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Hansel
authors.forename: Mark V
authors.initials: MV
authors.lastname: Larson
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Murray
authors.forename: John
authors.initials: J
authors.lastname: Debritto
authors.forename: Ross A
authors.initials: RA
authors.lastname: Dierkhising
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Gostout
mesh_terms: D053704:Capsule Endoscopy / Q000193:education* / Q000592:standards; D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum / Q000592:standards*; D005257:Fellowships and Scholarships / Q000592:standards*; D005762:Gastroenterology / Q000193:education* / Q000592:standards; D006801:Humans; D007421:Intestine, Small; D011446:Prospective Studies
keywords: ANOVA; Analysis of variance; CE; CapCT; Capsule Competency Test; capsule endoscopy