Author: Britton E, Sarkar S, Flanagan P
Abstract: INTRODUCTION: Training in Gastroenterology is currently defined by the JRCPTB curriculum. Whilst some guidance is provided on composition of clinical sessions its main focus is on overall training structure and expected clinical competencies and knowledge levels. Delivery of training is commonly arranged locally but there are currently no defined standards to describe the expected structure and standard of training within hospital placements. Consequently quality of training can be extremely variable. For the first time we present comprehensive standards detailing the delivery of high quality training in Gastroenterology. METHODS: Aims To develop and validate standards for delivery of training in Gastroenterology. Methods Standards were developed by consensus opinion by trainees and consultants including those with relevant subspecialist interests. Refinement of the standards was achieved by further peer review and pilot studies. In all there were 10 domains (inpatients, outpatients, endoscopy, HPB, IBD, luminal, nutrition, GIM, education, teaching) each with 5 possible grades (unacceptable, minimum, average, good, excellent). All points within the lowest grade had to be achieved before higher grade could be awarded. All units were then assessed against the standards with completion of the form by consensus trainee opinion. Overall assessment of individual units was also performed by consensus opinion and using a likert scale. RESULTS: 9 hospitals were assessed and significant variations in training quality were identified with large variation in overall grade attainment (range 22-94%). Overall grade and% grade attainment correlated accurately with overall consensus opinion on the relative strengths of units. Poorly performing units were reliably identified and relative strengths of units highlighted. Likert scale assessment was shown to be unreliable with consistently high scores across all units even when overall assessment was poor. CONCLUSION: Formal standards define how to deliver high quality training, allow objective assessment of units and highlight specific deficiencies in training enabling targeted improvement in delivery. The standards were more reliable than existing methods of assessment. These standards hold the potential to significantly improve training in Gastroenterology in the UK. DISCLOSURE OF INTEREST: E. Britton: None Declared, S. Sarkar: None Declared, P. Flanagan Grant/research support from: Awarded a Shire innovation fund for SpRs.
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