Acquisition of competency in endoscopic skills (ACES) during training: A multicenter study

O. W. Cass, M. L. Freeman, J. Cohen, G. Zuckerman, J. Watkins, J. Nord, G. R. Locke, D. Jensen, D. Diehl, M. Cerulli, K. Lyche, M. Fennerty, S. Edmundowicz, K. Etzkom, F. Al-Kawas, D. Cave, G. Lehman

Research output: Contribution to journalArticlepeer-review

57 Scopus citations


Purpose: To define the rate at which GI fellows attain technical competency in diagnostic esophagogastroduodenoscopy (EGD) and colonoscopy (Colon). Methods: The performance of 135 trainees was recorded by 243 mentors during consecutive procedures. Endpoints for EGD included intubating the esophagus and pylorus; for Colon, intubating the splenic flexure and the cecum; for both, recognizing and identifying abnormalities as well as a subjective grade of competency. Data on 11213 EGDs and 6889 Colons done between 7/1/94 and 10/15/95 were analyzed using Paradox and Excel. Results: The success of the trainees in meeting all endpoints are displayed below (mean±95% CI). The subjective grade paralleled objective endpoints. Because grading compliance was not universal, ongoing comparison with trainee logs will shift these curves right. Conclusions: An average trainee needs over 130 EGDs and 140 Colons to meet all criteria 90% of the time. Since some procedures were missed, these numbers must be viewed as minimum estimates. Standards of training (100 procedures each) are too low. Funding provided by: Hennepin Faculty Associates, ASGE, AGA, and ACG.

Original languageEnglish (US)
Pages (from-to)308
Number of pages1
JournalGastrointestinal endoscopy
Issue number4
StatePublished - 1996

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology


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