AN EVALUATION OF THE NATIONAL CLINICAL ENDOSCOPIST TRAINING PROGRAMME IN WALES

Introduction

Increased demand for endoscopy has created a need to increase the number of Clinical Endoscopists (CEs) contributing to service delivery. From April 2019 CEs were recruited to an accelerated programme of blended training interventions (Core teaching; Masters level modules; Simulation; JAG courses; online lesion recognition (SLATE) courses; Training lists; and Online Tutorials) - providing a pathway from novice to JAG certification within 12 months for Upper GI endoscopy, and 2 years for Colonoscopy.

Methods

We conducted quantitative and qualitative evaluation mapped to a logic model of the impact and effectiveness of two CE cohorts using triangulated evidence sources - literature review; workplace observation, surveys and interviews with trainees; interviews with stakeholders – trainers and mentors; discussions with course leaders; Data from the Cognitive Load Inventory for Colonoscopy (CLIC) survey; and Programme outcome data.

Results

Of ten trainees evaluated, one resigned (lack of local support). COVID adversely affected time taken to complete training – six completed all elements of training in time (3 JAG Certified, 3 in process of certification); three still in training were all redeployed. All trainees and trainers agreed the programme supports the development of technical skills required for the CE role. Endoscopic non-technical skills (ENTS) were highlighted as important – lesion recognition, decision-making, report writing & patient management – and take time to develop. All trainees reported positive impact on them personally, their career prospects and on their Units. They enjoyed peer learning and developed new skills in negotiating with colleagues and advocating for patients. Prior experience in an endoscopy unit correlated with better progress through the course and older trainees reported less extrinsic cognitive load. A dedicated trainer was critical to success, supported rapid progression and resolved training issues more effectively. Lack of training lists was the biggest barrier to progression. Academic supervision and support was valued. Trainers felt selection of the ‘right’ trainee was critical and wanted greater involvement in the selection process. A number of areas for programme improvement have been identified – recruitment process, trainer involvement in induction, programme manual, training agreements, developing independent prescribing competency.

Conclusions

The blended CE training pathway supports the acquisition of technical skills and ENTS from novice to JAG Certification. Qualitative review has highlighted several areas where the programme can be improved.