Lars Konge1, Morten Bo Søndergaard Svendsen2, Louise Preisler3, Lars Bo Svendsen3, Yoon Soo Park4. 1. a Copenhagen Academy for Medical Education and Simulation (CAMES) , The Capital Region of Denmark , Copenhagen , Denmark. 2. b Marine Biological Laboratory, Department of Biology , University of Copenhagen , Helsingør , Denmark. 3. c Department of Surgery, C-Tx , Copenhagen University Hospital Rigshospitalet , Copenhagen , Denmark. 4. d Department of Medical Education , University of Illinois Chicago , Chicago , IL , USA.
Abstract
OBJECTIVES: To develop a reliable method of assessing competence in colonoscopy based on multiple sources. MATERIALS AND METHODS: Physicians with varying degrees of experience in colonoscopy performed two colonoscopies each in a standardized simulated environment. Their performances were assessed under direct observation by an expert rater and by automatic computerized analysis of operator movements and scope movements, respectively. Reliability (Cronbach's alpha) for subjective assessment, time to cecum, analysis of operator movement and analysis of scope movements were calculated. Composite score calculations were used to explore different combinations of the measures. RESULTS: Twenty physicians were included in the study. The reliability (Cronbach's alpha) were 0.92, 0.57, 0.87 and 0.55 for the subjective score assessed under direct observation, time to cecum, distance between operator's hands and colonoscopy progression score, respectively. Equal weight (=25%) to all four methods resulted in a reliability of 0.91 and optimal weighting of the methods (55%, 10%, 25% and 10%, respectively) resulted in a maximum reliability of 0.95. CONCLUSION: Combining subjective expert ratings with automated objective assessments results in a less biased and more reliable assessment of competence in colonoscopy.
OBJECTIVES: To develop a reliable method of assessing competence in colonoscopy based on multiple sources. MATERIALS AND METHODS: Physicians with varying degrees of experience in colonoscopy performed two colonoscopies each in a standardized simulated environment. Their performances were assessed under direct observation by an expert rater and by automatic computerized analysis of operator movements and scope movements, respectively. Reliability (Cronbach's alpha) for subjective assessment, time to cecum, analysis of operator movement and analysis of scope movements were calculated. Composite score calculations were used to explore different combinations of the measures. RESULTS: Twenty physicians were included in the study. The reliability (Cronbach's alpha) were 0.92, 0.57, 0.87 and 0.55 for the subjective score assessed under direct observation, time to cecum, distance between operator's hands and colonoscopy progression score, respectively. Equal weight (=25%) to all four methods resulted in a reliability of 0.91 and optimal weighting of the methods (55%, 10%, 25% and 10%, respectively) resulted in a maximum reliability of 0.95. CONCLUSION: Combining subjective expert ratings with automated objective assessments results in a less biased and more reliable assessment of competence in colonoscopy.
Authors: Andreas S Vilmann; Christian Lachenmeier; Morten Bo S Svendsen; Bo Soendergaard; Yoon S Park; Lars Bo Svendsen; Lars Konge Journal: Endosc Int Open Date: 2022-01-14