Endoscopy Training Strategy

Glen Doherty

St Vincent’s University Hospital/University College Dublin

Much done, much more to do!

National Endoscopy Training Committee

Training Lead – Glen DohertyProgramme Co-ordinator - Grace O’Sullivan

Chris Steele - National Endoscopy Clinical Lead (HSE)

Fiachra Cooke (RCSI)Debbie McNamara (RCSI)Paul Mc Cormick (RCSI)Jan Leyden/Valerie Byrnes (NSD -RCPI)Deirdre McNamara (RCPI)Danny Cheriyan (RCPI)Barbara Ryan (ISG)

Carla Flanagan – National Endoscopy Nurse Lead (HSE)

4

Pathway to Competency in Endoscopy

Theory Hands – on Training CPD

Skills

Acq

uis

ition

Kn

ow

led

ge

Introduction

Simulators

Observed Procedures

Assisted Procedures

Supervised Procedures

Basic Skills Advanced SkillsBasic Skills

DOPS

FinalCert

Independent Procedures

5

Pathway to Competency in Endoscopy

Theory Hands – on Training CPD

Skills

Acq

uis

ition

Kn

ow

led

ge

Introduction

Simulators

Observed Procedures

Assisted Procedures

Supervised Procedures

Basic Skills Advanced SkillsBasic Skills

DOPS

FinalCert

Independent Procedures

See a few, then do lots, eventually teach some

6

Pathway to Competency in Endoscopy

Theory Hands – on Training CPD

Skills

Acq

uis

ition

Kn

ow

led

ge

Introduction

Simulators

Observed Procedures

Assisted Procedures

Supervised Procedures

Basic Skills Advanced SkillsBasic Skills

DOPS

FinalCert

Independent Procedures

I’m in the caecum, what do I do now?

7

Pathway to Competency in Endoscopy

Theory Hands – on Training CPD

Skills

Acq

uis

ition

Kn

ow

led

ge

Introduction

Simulators

Observed Procedures

Assisted Procedures

Supervised Procedures

Basic Skills Advanced SkillsBasic Skills

DOPS

FinalCert

Independent Procedures

I’m in the caecum, what do I do now?

Better call for help dear, this is an OGD….

Improving the applications of DOPS

Improving the applications of DOPS

10

Pathway to Competency in Endoscopy

Theory Hands – on Training CPD

Skills

Acq

uis

ition

Kn

ow

led

ge

Introduction

Simulators

Observed Procedures

Assisted Procedures

Supervised Procedures

Basic Skills CompetencyBasic Skills

DOPS DOPSProvCert

Mentored Practice

KPI

FinalCert

Independent Procedures

DOPS

DOPS

Provisional Certification ‘R Plates’

Final Certification - Colonoscopy

Key National Requirements

• E- Log Books for all trainees (iJETS)

• Utilise Endoscopy NQI Programme

• Annual ‘Endoscopy Focussed’ Appraisal

• Access to Basic and Advanced GI skills courses

• Electronic learning resources through ISG/Colleges

• Network for Training Leads – Develop infrastructure

• Designated Training Centres for Advanced Therapeutics

Training – the achilles heel of endoscopy

Train the Colonoscopy Trainer (TCT)

Requirements for Trainers

• Participation in NQI Programme

• Participation in TCT Course

• Education in DOPS techniques and DOPyS

• Faculty in Basic and Advanced Skills Courses

• Facilitate Summative DOPS Certification

• ‘Buy –in’ to value of endoscopy training

• Preference in allocation of trainees

STEPS Programme

STEPS-FSSTFoundation Skills & Simulator Training (BST)

STEPS-BSCBasic Endoscopy Skills Course (for HST)

STEPS-ACSAdvanced colonoscopy skills (for HST)

STEPS-PSCPolypectomy Skills Course (for HST)

STEPS-EHCEndoscopic Haemostasis Course (for HST)

STEPS- CECColonoscopy Excellence for Consultants(Consultants)

STEPS-TCTTrain the Colonoscopy Trainer(Consultants)

STEPS-APSAdvanced Polypectomy Skills (Consultants)

Key Aims

Consolidate Operation of Existing Courses

Create New Course for HST/Consultants

Support Course Faculty/Centres

Future – ERCP/EUS and Advances Therapy

Colonoscopy – Everyone Can Get Better

Colonoscopy – Everyone Can Get Better

Endoscopy ANP Training Programme

• UCD School of Nursing, Midwifery and Health Systems (in partnership with St Vincent’s University Hospital)

• MSc in Advanced Nursing Practice (Gastroenterology Care : Colorectal Screening and Disease Management)

• 2 year programme – Blended Learning

• Core (generic) modules from existing MSc programme

• Dedicated modules in gastroenterology/endoscopy

• Hands-on skills based training in endoscopy

Endoscopy Training Strategy (2019-22)

To establish a National Endoscopy Training Committee for Gastro-intestinal endoscopy which comprises representation from the both RCPI, RCSI and other key stakeholders

To undertake a detailed baseline survey of the endoscopy training experience of current specialist gastroenterology and higher surgical trainees

To establish a support network for endoscopy training leads to provide a common approach and to facilitate a gap analysis for training equipment and structures across the country

To develop a mechanism to identify and analyse trainee data within the NQAIS programme

To develop and implement a cohesive joint approach to the certification of training in GI endoscopy within the existing specialist training programmes, incorporating the use of NQAIS quality reports into an electronic log of experience and competency.

To improve existing GI endoscopy training courses, promote uptake of train the trainer courses for GI endoscopy and to develop skills enhancement courses for established practitioners

To establish a sustainable framework for the training of nurse endoscopists in Ireland

To support the delivery of quality training and professional development for endoscopy nurses in Ireland

Programme Goals

Structured Training

Certification Infrastructure

Quality Education

Ireland Endoscopy

Training Programme

RCSI RCPI

HSE/NTDP

ISG

Questions