title: A competency framework for colonoscopy training derived from cognitive task analysis techniques and expert review.
abstract: BACKGROUND
  Colonoscopy is a difficult cognitive-perceptual-motor task. Designing an appropriate instructional program for such a task requires an understanding of the knowledge, skills and attitudes underpinning the competency required to perform the task. Cognitive task analysis techniques provide an empirical means of deriving this information.
  
  
  METHODS
  Video recording and a think-aloud protocol were conducted while 20 experienced endoscopists performed colonoscopy procedures. "Cued-recall" interviews were also carried out post-procedure with nine of the endoscopists. Analysis of the resulting transcripts employed the constant comparative coding method within a grounded theory framework. The resulting draft competency framework was modified after review during semi-structured interviews conducted with six expert endoscopists.
  
  
  RESULTS
  The proposed colonoscopy competency framework consists of twenty-seven skill, knowledge and attitude components, grouped into six categories (clinical knowledge; colonoscope handling; situation awareness; heuristics and strategies; clinical reasoning; and intra- and inter-personal).
  
  
  CONCLUSIONS
  The colonoscopy competency framework provides a principled basis for the design of a training program, and for the design of formative assessment to gauge progress towards attaining the knowledge, skills and attitudes underpinning the achievement of colonoscopy competence.
authors.affiliation: School of Human Movement Studies, The University of Queensland, Brisbane, Australia. czupanc@hms.uq.edu.au.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Zupanc
authors.affiliation: Minerals Industry Safety and Health Centre, The University of Queensland, Brisbane, Australia. r.burgesslimerick@uq.edu.au.
authors.forename: Robin
authors.initials: R
authors.lastname: Burgess-Limerick
authors.affiliation: School of Psychology, The University of Queensland, Brisbane, Australia. a.hill@psy.uq.edu.au.|Clinical Skills Development Service, Queensland Health, Brisbane, Australia. a.hill@psy.uq.edu.au.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hill
authors.affiliation: School of Human Movement Studies, The University of Queensland, Brisbane, Australia. sriek@hms.uq.edu.au.
authors.forename: Stephan
authors.initials: S
authors.lastname: Riek
authors.affiliation: School of Human Movement Studies, The University of Queensland, Brisbane, Australia. gwallis@hms.uq.edu.au.
authors.forename: Guy M
authors.initials: GM
authors.lastname: Wallis
authors.affiliation: School of Human Movement Studies, The University of Queensland, Brisbane, Australia. a.plooy@hms.uq.edu.au.
authors.forename: Annaliese M
authors.initials: AM
authors.lastname: Plooy
authors.affiliation: School of Psychology, The University of Queensland, Brisbane, Australia. m.horswill@psy.uq.edu.au.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Horswill
authors.affiliation: School of Psychology, The University of Queensland, Brisbane, Australia. marcus.watson@health.qld.gov.au.|Clinical Skills Development Service, Queensland Health, Brisbane, Australia. marcus.watson@health.qld.gov.au.|School of Medicine, The University of Queensland, Mayne Medical Building, Herston Road, Brisbane, QLD, 4006, Australia. marcus.watson@health.qld.gov.au.
authors.forename: Marcus O
authors.initials: MO
authors.lastname: Watson
authors.affiliation: School of Psychology, The University of Queensland, Brisbane, Australia. d.hewett@uq.edu.au.|School of Medicine, The University of Queensland, Mayne Medical Building, Herston Road, Brisbane, QLD, 4006, Australia. d.hewett@uq.edu.au.
authors.forename: David G
authors.initials: DG
authors.lastname: Hewett
mesh_terms: D000328:Adult; D001315:Australia; D002983:Clinical Competence / Q000592:standards*; D003071:Cognition / Q000502:physiology; D020685:Colonoscopes; D003113:Colonoscopy / Q000193:education* / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D013647:Task Performance and Analysis; D014741:Video Recording