(GiECATKIDS), a task‐specific seven‐item global rating scale that assesses more holistic aspects of the skill and a structured 18‐item checklist that outlines key steps. Using Delphi methodology, the GiECATKIDS was developed by 41 pediatric endoscopy experts from 28 North American hospitals, and addresses performance of all components of a colonoscopy procedure, including pre‐, intra‐, and postprocedural aspects. In one study of 116 colonoscopies performed by 56 pediatric endoscopists (25 novice, 21 intermediate and 10 experienced) from three North American academic hospitals, the GiECATKIDS was found to be a reliable and valid measure that can be used in a formative manner throughout training [53]. The GiECATKIDS has also been found to have strong interrater reliability, excellent test–retest reliability, evidence of content, response process and internal structure validity, discriminative validity (ability to detect differences in skill level), validity evidence of associations with other variables thought to reflect endoscopic competence (e.g., ileal intubation rate), and educational usefulness [53].
Ultimately, the integration of rigorously developed assessment tools, such as the GiECATKIDS, will provide a means to document progress throughout the training cycle. In addition, these tools can be used to support trainees’ learning through the provision of instructive feedback, allow program directors to monitor skill acquisition to ensure trainees are progressing, facilitate identification of skill deficits, and help ensure readiness for independent practice [51,54]. Looking to the future, the universal adoption of robust assessment tools by pediatric gastroenterology training programs across jurisdictions would be useful, as it would generate aggregate data that could be used to develop average learning curves of pediatric endoscopists. These data could also be used to define milestones for pediatric endoscopists at different levels of training and help to establish minimal performance‐based benchmark criteria for competence in pediatric endoscopy procedures to support competency‐based training.
Conclusion
Differences between pediatric and adult endoscopic practice highlight the need for pediatric‐specific approaches to training and assessment. Intense efforts have been made over the past decade to define the competencies required to carry out pediatric endoscopic procedures and to develop tools to support competency‐based assessment. In addition, new instructional aids, such as magnetic imaging and simulation, have been introduced with the aim of enhancing training quality and accelerating skills acquisition. Ultimately, competency assessment metrics should be inextricably woven within a core endoscopy curriculum to ensure optimal integration of teaching, learning, feedback, and assessment throughout the entire spectrum of training in pediatric gastrointestinal procedures.
•See companion website for videos relating to this chapter topic: www.wiley.com/go/gershman3e
REFERENCES
1 1 Fitts A, Posner M. Human Performance. Brooks‐Cole, Belmont, CA, 1967.
2 2 Rogers DA, Regehr G, MacDonald J. A role for error training in surgical technical skill instruction and evaluation. Am J Surg 2002, 183(3), 242–245.
3 3 Shah SG, Brooker JC, Williams CB, Thapar C, Saunders BP. Effect of magnetic endoscope imaging on colonoscopy performance, a randomised controlled trial. Lancet 2000, 356(9243), 1718–1722.
4 4 Mark‐Christensen A, Brandsborg S, Iversen LH. Magnetic endoscopic imaging as an adjuvant to elective colonoscopy, a systematic review and meta‐analysis of randomized controlled trials. Endoscopy.2015, 47(3), 251–261.
5 5 Shah SG, Thomas‐Gibson S, Lockett M, et al. Effect of real‐time magnetic endoscope imaging on the teaching and acquisition of colonoscopy skills: results from a single trainee. Endoscopy 2003, 35(5), 421–425.
6 6 Walsh CM, Sherlock ME, Ling SC, Carnahan H. Virtual reality simulation training for health professions trainees in gastrointestinal endoscopy. Cochrane Database Syst Rev 2012, 6, CD008237.
7 7 Singh S, Sedlack RE, Cook DA. Effects of simulation‐based training in gastrointestinal endoscopy: systematic review and meta‐analysis. Clin Gastroenterol Hepatol 2014, 12(10), 1611–1623.
8 8 Ziv A, Wolpe PR, Small SD, Glick S. Simulation‐based medical education: an ethical imperative. Acad Med 2003, 78(8), 783–788.
9 9 Cook DA, Brydges R, Zendejas B, Hamstra SJ, Hatala R. Mastery learning for health professionals using technology‐enhanced simulation: a systematic review and meta‐analysis. Acad Med 2013, 88(8), 1178–1186.
10 10 Hatala R, Cook DA, Zendejas B, Hamstra SJ, Brydges R. Feedback for simulation‐based procedural skills training: a meta‐analysis and critical narrative synthesis. Adv Health Sci Educ Theory Pract 2014, 19(2), 251–272.
11 11 Cook DA, Hamstra SJ, Brydges R, et al. Comparative effectiveness of instructional design features in simulation‐based education: systematic review and meta‐analysis. Med Teach 2013, 35(1), e867–898.
12 12 Issenberg SB, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ. Features and uses of high‐fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach 2005, 27(1), 10–28.
13 13 Grover SC, Scaffidi MA, Garg A, et al. A simulation‐based training curriculum of progressive fidelity and complexity improves technical and non‐technical skills in colonoscopy: a blinded, randomized trial. Gastrointest Endosc 2015, 81(5S), AB324–AB325.
14 14 Walsh CM, Ling SC, Wang CS, Carnahan H. Concurrent versus terminal feedback: it may be better to wait. Acad Med 2009, 84(10 Suppl), S54–57.
15 15 Grover SC, Garg A, Yu JJ, Ramsaroom A, Grantcharov T, Walsh CM. A prospective, randomized, blinded trial of curriculum‐based simulation training in colonoscopy as a means to enhance both technical and non‐technical skills. Gastrointest Endosc 2014, 79(5S), Abstract 433.
16 16 Coderre S, Anderson J, Rostom A, McLaughlin K. Training the endoscopy trainer: from general principles to specific concepts. Can J Gastroenterol 2010, 24(12), 700–704.
17 17 Walsh CM, Anderson JT, Fishman DS. An evidence‐based approach to training pediatric gastrointestinal endoscopy trainers. J Pediatr Gastroenterol Nutr 2017, 64(4), 501–504.
18 18 Waschke KA, Anderson J, Macintosh D, Valori RM. Training the gastrointestinal endoscopy trainer. Best Pract Res Clin Gastroenterol 2016, 30(3), 409–419.
19 19 Anderson JT. Assessments and skills improvement for endoscopists. Best Pract Res Clin Gastroenterol 2016, 30(3), 453–471.
20 20 Canadian Association of Gastroenterology. Skills Enhancement for Endoscopy Program. www.cag‐acg.org/education/see‐program.
21 21 Shute VJ. Focus on formative feedback. Rev Educ Res 2008, 78(1), 153–189.
22 22 Epstein RM. Assessment in medical education. N Engl J Med 2007, 356(4), 387–396.
23 23 Govaerts MJB, van der Vleuten CPM, Schuwirth LWT, Muijtjens AMM. Broadening perspectives on clinical performance assessment, rethinking the nature of in‐training assessment. Adv Health Sci Educ Theory Pract 2007, 12(2), 239–260.
24 24 Rose S, Fix OK, Shah BJ, et al. Entrustable professional activities for gastroenterology fellowship training. Gastrointest Endosc 2014, 80(1), 16–27.
25 25 Frank JR, Mungroo R, Ahmad Y, Wang M, de Rossi S, Horsley T. Toward a definition of
