The gastrointestinal endoscopy competency assessment tool for pediatric colonoscopy

Objectives: Validated assessment tools are required to support competencybased education. We aimed to assess the reliability and validity of the Gastrointestinal Endoscopy Competency Assessment Tool for Pediatric Colonoscopy (GiECATKIDS), an instrument developed by 41 North American experts using Delphi methodology. Methods: GiECATKIDS consists of a 7-item global rating scale (GRS) and an 18-item checklist (CL). An attending physician assessed 104 colonoscopies performed at 3 North American hospitals by 56 endoscopists, including 25 KIDS ICC1⁄4 0.88; GRS: ICC1⁄4 0.79; CL: ICC1⁄4 0.89). Test–retest reliability was excellent (total: ICC1⁄4 0.94; GRS: ICC1⁄4 0.94; CL: ICC1⁄4 0.84). GiECATKIDS total, GRS, and CL scores differed significantly among novice, intermediate, and advanced endoscopists (P< 0.001). There was a significant positive correlation (P< 0.001) between scores and number of previous colonoscopies (total: r1⁄4 0.91, GRS: r1⁄4 0.92, CL: r1⁄4 0.84), cecal comparing experience level with scores. Concurrent validity was assessed by correlating scores with colonoscopy experience, cecal and terminal ileal intubation rate (total: r1⁄4 0.82, GRS: r1⁄4 0.85, CL: r1⁄4 0.77), ileal intubation rate (total: r1⁄4 0.82, GRS: r1⁄4 0.82, CL: r1⁄4 0.80), and physician global assessment (total: r1⁄4 0.95, GRS: r1⁄4 0.94, CL: r1⁄4 0.89). Conclusions: The GiECATKIDS demonstrates strong reliability and validity as a measure of performance of pediatric colonoscopy that can be used to support training and assessment.