Validity evidence for endoscopic ultrasound competency assessment tools: Systematic review

Alessandra Ceccacci¹, Harneet Hothi², Rishad Khan³, Nikko Gimpaya⁴, Brian P H Chan^{5

1

3}, Nauzer Forbes⁶, Paul James^{7

1

3}, Daniel Jeffry Low^{5

1

3}, Jeffrey Mosko^{8

1

3

9}, Elaine T Yeung^{5

1

3}, Catharine M Walsh^{10

11}, Samir C Grover^{1

5

3

4}

Affiliations

¹ Department of Medicine, University of Toronto, Toronto, Canada.
² Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
³ Division of Gastroenterology and Hepatology, University of Toronto, Toronto, Canada.
⁴ Scarborough Health Network Research Institute, Scarborough Health Network, Scarborough, Canada.
⁵ Division of Gastroenterology, Scarborough Health Network, Scarborough, Canada.
⁶ Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.
⁷ Division of Gastroenterology, University Health Network, Toronto, Canada.
⁸ Division of Gastroenterology, St Michael's Hospital, Toronto, Canada.
⁹ Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Canada.
¹⁰ Division of Gastroenterology, Hepatology, and Nutrition, and the Research and Learning Institutes, The Hospital for Sick Children, Toronto, Canada.
¹¹ Department of Pediatrics and the Wilson Centre, University of Toronto Temerty Faculty of Medicine, Toronto, Canada.

PMID: 39691740
PMCID: PMC11651920
DOI: 10.1055/a-2465-7283

Review

Validity evidence for endoscopic ultrasound competency assessment tools: Systematic review

Alessandra Ceccacci et al. Endosc Int Open. 2024.

. 2024 Dec 17;12(12):E1465-E1475.

doi: 10.1055/a-2465-7283. eCollection 2024 Dec.

Authors

Affiliations

¹ Department of Medicine, University of Toronto, Toronto, Canada.
² Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
³ Division of Gastroenterology and Hepatology, University of Toronto, Toronto, Canada.
⁴ Scarborough Health Network Research Institute, Scarborough Health Network, Scarborough, Canada.
⁵ Division of Gastroenterology, Scarborough Health Network, Scarborough, Canada.
⁶ Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.
⁷ Division of Gastroenterology, University Health Network, Toronto, Canada.
⁸ Division of Gastroenterology, St Michael's Hospital, Toronto, Canada.
⁹ Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Canada.
¹⁰ Division of Gastroenterology, Hepatology, and Nutrition, and the Research and Learning Institutes, The Hospital for Sick Children, Toronto, Canada.
¹¹ Department of Pediatrics and the Wilson Centre, University of Toronto Temerty Faculty of Medicine, Toronto, Canada.

PMID: 39691740
PMCID: PMC11651920
DOI: 10.1055/a-2465-7283

Abstract

Background and study aims Competent endoscopic ultrasound (EUS) performance requires a combination of technical, cognitive, and non-technical skills. Direct observation assessment tools can be employed to enhance learning and ascertain clinical competence; however, there is a need to systematically evaluate validity evidence supporting their use. We aimed to evaluate the validity evidence of competency assessment tools for EUS and examine their educational utility. Methods We systematically searched five databases and gray literature for studies investigating EUS competency assessment tools from inception to May 2023. Data on validity evidence across five domains (content, response process, internal structure, relations to other variables, and consequences) were extracted and graded (maximum score 15). We evaluated educational utility using the Accreditation Council for Graduate Medical Education framework and methodological quality using the Medical Education Research Quality Instrument (MERSQI). Results From 2081 records, we identified five EUS assessment tools from 10 studies. All tools are formative assessments intended to guide learning, with four employed in clinical settings. Validity evidence scores ranged from 3 to 12. The EUS and ERCP Skills Assessment Tool (TEESAT), Global Assessment of Performance and Skills in EUS (GAPS-EUS), and the EUS Assessment Tool (EUSAT) had the strongest validity evidence with scores of 12, 10, and 10, respectively. Overall educational utility was high given ease of tool use. MERSQI scores ranged from 9.5 to 12 (maximum score 13.5). Conclusions The TEESAT, GAPS-EUS, and EUSAT demonstrate strong validity evidence for formative assessment of EUS and are easily implemented in educational settings to monitor progress and support learning.

Keywords: Endoscopic ultrasonography; Performance and complications; Quality and logistical aspects; Training.

The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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Conflict of interest statement

Conflict of Interest N. Forbes does not have any current conflicts of interest but in the last 3 years was a consultant for AstraZeneca, a consultant and speaker for Boston Scientific, and a consultant and speaker for Pentax Medical. He received research funding from Pentax Medical. J. D. Mosko has been a consultant and speaker for Boston Scientific, ERBE, Fuji, Medtronic, Pendopharm, and Steris. He received research funding from Boston Scientific and ERBE. S. C. Grover has been a speaker for Abbvie, a stockholder and employee of Volo Healthcare, on the advisory board for Amgen, BioJAMP, Pfizer, and Sanofi, and has received education support from Fresenius Kabi, BioJAMP, Celltrion, Takeda, and Pfizer. A. Ceccacci, H. Hothi, R. Khan, N. Gimpaya, B. Chan, P. D. James, D. J. Low, E. Yeung, and C. M. Walsh do not have any conflicts of interest to indicate.

Figures

**Fig. 1**
EUS competency assessment tool validity evidence scores.

See this image and copyright information in PMC

References

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Validity evidence for endoscopic ultrasound competency assessment tools: Systematic review

Affiliations

Validity evidence for endoscopic ultrasound competency assessment tools: Systematic review

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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