title: Gastrointestinal Endoscopy Competency Assessment Tool: development of a procedure-specific assessment tool for colonoscopy.
abstract: BACKGROUND
  Ensuring competence remains a seminal objective of endoscopy training programs, professional organizations, and accreditation bodies; however, no widely accepted measure of endoscopic competence currently exists.
  
  
  OBJECTIVE
  By using Delphi methodology, we aimed to develop and establish the content validity of the Gastrointestinal Endoscopy Competency Assessment Tool for colonoscopy.
  
  
  METHODS
  An international panel of endoscopy experts rated potential checklist and global rating items for their importance as indicators of the competence of trainees learning to perform colonoscopy. After each round, responses were analyzed and sent back to the experts for further ratings until consensus was reached.
  
  
  METHODS
  Consensus was defined a priori as ≥80% of experts, in a given round, scoring ≥4 of 5 on all remaining items.
  
  
  RESULTS
  Fifty-five experts agreed to be part of the Delphi panel: 43 gastroenterologists, 10 surgeons, and 2 endoscopy managers. Seventy-three checklist and 34 global rating items were generated through a systematic literature review and survey of committee members. An additional 2 checklist and 4 global rating items were added by Delphi panelists. Five rounds of surveys were completed before consensus was achieved, with response rates ranging from 67% to 100%. Seven global ratings and 19 checklist items reached consensus as good indicators of the competence of clinicians performing colonoscopy.
  
  
  CONCLUSIONS
  Further validation required.
  
  
  CONCLUSIONS
  Delphi methodology allowed for the rigorous development and content validation of a new measure of endoscopic competence, reflective of practice across institutions. Although further evaluation is required, it is a promising step toward the objective assessment of competency for use in colonoscopy training, practice, and research.
authors: Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada; The Wilson Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Catharine M
authors: CM
authors: Walsh
authors: Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
authors: Simon C
authors: SC
authors: Ling
authors: Division of Gastroenterology, St. Joseph's Health Centre, University of Western Ontario, Toronto, Ontario, Canada.
authors: Nitin
authors: N
authors: Khanna
authors: Division of Gastroenterology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors: Mary Anne
authors: MA
authors: Cooper
authors: Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors: Samir C
authors: SC
authors: Grover
authors: Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors: Gary
authors: G
authors: May
authors: Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
authors: Thomas D
authors: TD
authors: Walters
authors: Cancer Care Ontario, Queen's University, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors: Linda
authors: L
authors: Rabeneck
authors: Faculty of Health Sciences, Queen's University, Toronto, Ontario, Canada.
authors: Richard
authors: R
authors: Reznick
authors: Centre for Ambulatory Care Education, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; The Wilson Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Heather
authors: H
authors: Carnahan
mesh_terms: D057189:Checklist; D002983:Clinical Competence / Q000592:standards*; D003113:Colonoscopy / Q000193:education / Q000592:standards*; D032921:Consensus; D003697:Delphi Technique; D005260:Female; D006801:Humans; D008297:Male; D019984:Quality Indicators, Health Care