A more ambitious approach would be to develop a comprehensive set of highly-focused training modules and assessments, each targeting a specific competency component.
Therefore, a plausible alternative approach in relation to this competency component may be to develop a novel computer-based training methodology that, in a relatively short space of time, gives the trainee the equivalent of a career's worth of exposure to and practice at identifying abnormalities, in conjunction with timely and accurate performance feedback.
Intra-personal and inter-personal competency components refer to the affective and communication skills, and attitudes, required for safe and efficient colonoscopy.
The identification of competency components in the medical training literature has typically been achieved through the gathering of expert opinion [ 1, 2].
Simulation-based training, for example, has the potential to accelerate skill acquisition if it addresses one or more of the competency components in the proposed framework.
Ultimately, a proposed colonoscopy competency framework was identified comprising twenty-seven components components grouped into six categories: clinical knowledge; colonoscope handling; situation awareness; heuristics and strategies; clinical reasoning; and intra-personal and inter-personal (Fig. 1).
Twenty-seven components components (knowledge, skills and attitudes) were identified and grouped into six categories (clinical knowledge; colonoscope handling; situation awareness; heuristics and strategies; clinical reasoning; and intra- and inter-personal) within the Colonoscopy Competency Framework (Fig. 1).
A colonoscopy competency framework was identified consisting of twenty-seven components components grouped into six categories: clinical knowledge; colonoscope handling; situation awareness; heuristics and strategies; clinical reasoning; and intra- and inter-personal.
Cognitive task analysis methods (observation, a think-aloud protocol and cued-recall) and subsequent expert review were employed to identify the competency components exhibited by practicing endoscopists with the aim of providing a basis for future instructional design.
Appropriate attitudes towards procedural safety and patient care are one of the most important competency components for colonoscopy; it was apparent during analysis of the transcripts that these attitudes underpin most, if not all, behaviors and reasoning processes undertaken during the procedure.
At present, no commercially-available colonoscopy simulation device addresses all of the competency components, heuristics and strategies that we have identified [ 32]; hence, a potential application of our findings would be the development of more advanced virtual reality colonoscopy simulators with more comprehensive curricula to better aid in the teaching of colonoscopy.
