Structured assessment of competency in polypectomy

Currently, there is no national endoscopic database in England. Information regarding the volume of therapeutic endoscopic procedures such as polypectomy is obtained mainly from small prospective studies. We examined the Hospital Episode Statistics (HES) national database to assess the number of patients who underwent a therapeutic polypectomy for a primary diagnosis of a benign colorectal polyp over a 10 year period, as well as analysing outcomes from the first three years of bowel cancer screening at a single tertiary endoscopy centre. Despite the ubiquitous use of endoscopic snare polypectomy over the last four decades, there has been a void in formal training and assessment of polypectomy skills in the UK. We aimed to develop and validate an objective, structured assessment tool for assessing polypectomy competency in skilled accredited Bowel Cancer Screening endoscopists. This study led to the development of the DOPyS (Direct Observation of Polypectomy Skills) assessment tool. Validation and reliability of the DOPyS was demonstrated through assessment of polypectomy videos, performed by accredited Bowel Cancer Screening endoscopists, using Generalisability Theory (G theory). Construct validity of the DOPyS, and its ability to assess piecemeal Endoscopic Mucosal Resection, were determined through separate studies. The DOPyS validation studies highlighted variability in assessor scoring and DOPyS training days were held for Bowel Cancer Screening assessors in England, in order to align opinions prior to the implementation of the DOPyS into the Bowel Cancer Screening Accreditation Process in England. Finally, in an effort to provide a structure for improved polypectomy outcomes and referral systems, a study was performed to determine the difficulty ‘level’ of a polypectomy, based on polyp characteristics.EThOS - Electronic Theses Online ServiceGBUnited Kingdo