North of 100 and south of 500: where does the 'sweet spot' of colonoscopic competence lie?

摘要

Competence is defined as the possession of a required skill, knowledge, qualification, or capacity. From an endo-scopic standpoint, competence is the attainment of technical and cognitive milestones that enables the performance of a particular procedure at an acceptable standard. We, as educators, know competence when we see it. However, the journey to this educational summit has been strewn with a surprising lack of science. In this issue of Gastrointestinal Endoscopy, Spier et al1 tackle the vexing issue surrounding procedural competence in colonoscopy.. In their study, competence was defined as the ability to perform > 90% of colonoscopies independently during a month-long observation period. They have shown us again that the threshold for assessing competence is not an immutable, hallowed number. When the threshold of 140 colonoscopies, which has been published as the minimum number of procedures to have been completed before assessing competence, was used, no trainees exhibited a cecal intubation rate of > 90%.