Keynote Message

Increasing complexity within the healthcare system has led to a need for change within the current medical education training model. There has been a gradual shift from the traditional time and process-based format to a competency-based model that emphasizes clinical outcomes and patient-centered quality. Additionally, there has been an increased focus on assessing trainee ability with promotion of learner-centeredness.

In the field of Gastroenterology, the shift to a competency-based approach has led to changes in the educational approach to teaching endoscopy. Traditionally, programs relied on case number thresholds to ensure trainees achieved procedural competency. However, with the heightened emphasis on quality, the use of threshold numbers is now considered a poor surrogate marker for competence. Trainees are now increasingly expected to achieve certain quality metrics when performing endoscopic procedures before they are deemed competent. As the competency-based model emphasizes outcomes rather than the process, appropriate assessment is a critical component of training. Several tools/processes are available to ensure trainees in both procedural and non-procedural oriented programs are meeting developmental milestones.

In this session, the competency-based medical education paradigm will be further explored. We will also focus on the ACGME core competencies and the Next Accreditation System (NAS) assessment model as a framework for developing competency-based curricula. Strategies for evaluating trainees and specifically assessing the technical and non-technical components of endoscopic competence will also be discussed.

Key References

1.  Accreditation Council for Graduate Medical Education [USA]. 2009a. ACGME Outcome Project. Chicago: ACGME. http:// www.acgme.org/Outcome (VIN editor: link could not be accessed on 7/24/17).

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5.  Rizk MK, Sawhney MS, Cohen J, Pike IM, Adler DG, Dominitz JA, Lieb JG 2nd, Lieberman DA, Park WG, Shaheen NJ, Wani S. Quality indicators common to all GI endoscopic procedures. Gastrointest Endosc. 2015;81(1):3–16. DOI: 10.1016/j.gie.2014.07.055.

6.  Holmboe ES, Sherbino J, Long DM, Swing SR, Frank JR. The role of assessment in competency-based medical education. Med Teach. 2010;32(8):676–82. DOI: 10.3109/0142159X.2010.500704.