Development and Validation of a Multiple-Choice Question Paper in Basic Colonoscopy

Abstract

Factual knowledge underpins competence in all clinical skills. A multiple-choice question paper (MCQ) was designed as part of an accelerated colonoscopy training week (ACTW). In the United Kingdom, there are no validated methods of assessing core knowledge in colonoscopy. The aims of this study were to develop an MCQ paper, to demonstrate its construct validity, and to establish whether the ACTW improved core knowledge. Two 30-question MCQ papers (A and B) were designed. Delegates attending the British Society of Gastroenterology (BSG) 2004 meeting responded either to MCQ paper A or B. Demographic data were collected on their experience in colonoscopy. Doctors attending the ACTW completed either MCQ paper A or B before the course, and the other paper after the course. Seventy-eight delegates at the BSG meeting completed the MCQ. There was a significant difference in the scores between those who had carried out less than 200 colonoscopies (mean 32.5 %) and those who had performed more than 200 (mean 58.4 %; P < 0.0001). Seventeen doctors attending the ACTW completed the MCQ. The mean score for papers A and B increased significantly following the course--57.2 % before the ACTW, 67 % after it ( P = 0.003). This MCQ is capable of differentiating between endoscopists with different levels of experience in colonoscopy. Doctors attending an ACTW significantly improve their knowledge in colonoscopy. A validated MCQ such as this could be used as part of the assessment process to ascertain competence in colonoscopy.