Can endoscopists accurately self-assess performance during simulated colonoscopic polypectomy? A prospective, cross-sectional study.

Ansell, James; Hurley, Joanna J; Horwood, James; Rizan, Chantelle; Arnaoutakis, Konstantinos; Goddard, Stuart; Warren, Neil; Torkington, Jared

BACKGROUND The aim of this study was to establish if endoscopists can reliably self-assess their ability to perform simulated colonic polypectomy. METHODS Novices, intermediates, advanced, and experts performed a video-recorded polypectomy task using the Welsh Institute for Minimal Access Therapy (WIMAT) colonoscopy suitcase simulator. This involved removal of a simple polyp (A) and a complex polyp (B). Participants self-assessed themselves using a Direct Observation of Polypectomy Skills (DOPyS) assessment form. Two blinded, independent, Joint Advisory Group on Gastrointestinal Endoscopy (JAG) accredited assessors graded each performance using the same DOPyS scoring. The Spearman coefficient was used to determine the correlation between self and assessors' scores. RESULTS Eighty participants completed the task. There was a weak correlation between assessors' scores and self-assessment scores for all groups (novices: ρ = -.44, P = .85; intermediates: ρ = -.16, P = .51; advanced: ρ = .16, P = .50; and experts: ρ = .07, P = .76). There was a strong correlation between scores from assessor 1 and 2 for polyp A (ρ = .80, P ≤ .01) and polyp B (ρ = .80, P ≤ .01). CONCLUSIONS The correlation between self-assessment and assessors' scores is weak. Novices and intermediates underestimate performance, whereas advanced and experts overestimate performance. Regular feedback may improve accuracy.