| Summary: | No === Objective: The aim of this study was to determine the
number of OGDs (oesophago-gastro-duodenoscopies)
trainees need to perform to acquire competency in terms
of successful unassisted completion to the second part
of the duodenum 95% of the time.
Design: OGD data were retrieved from the trainee
e-portfolio developed by the Joint Advisory Group on GI
Endoscopy ( JAG) in the UK. All trainees were included
unless they were known to have a baseline experience of
>20 procedures or had submitted data for <20
procedures. The primary outcome measure was OGD
completion, defined as passage of the endoscope to the
second part of the duodenum without physical
assistance. The number of OGDs required to achieve a
95% completion rate was calculated by the moving
average method and learning curve cumulative
summation (LC-Cusum) analysis. To determine which
factors were independently associated with OGD
completion, a mixed effects logistic regression model
was constructed with OGD completion as the outcome
variable.
Results: Data were analysed for 1255 trainees over 288
centres, representing 243 555 OGDs. By moving average
method, trainees attained a 95% completion rate at 187
procedures. By LC-Cusum analysis, after 200 procedures,
>90% trainees had attained a 95% completion rate.
Total number of OGDs performed, trainee age and
experience in lower GI endoscopy were factors
independently associated with OGD completion.
Conclusions: There are limited published data on the
OGD learning curve. This is the largest study to date
analysing the learning curve for competency acquisition.
The JAG competency requirement for 200 procedures
appears appropriate
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