Abstract

The American Society of Gastrointestinal Endoscopy (ASGE) defines competency as the minimum level of skill, knowledge, and/or experience derived from training that will enable the proficient performance of a task or procedure.1 Training in gastrointestinal endoscopy, for most of us who are involved in it, was performed in hospitals during our residency or fellowship. The acquisition of competence required and still requires continuous supervision by tutors or mentors trained as teachers, and takes a long time to avoid errors or adverse events during the development of the learning curve. The greater the complexity of the procedure, the greater the need for close supervision. Continuous supervision prolongs the procedures, thus reducing the number of procedures that can be programmed on a daily basis. This has financial implications for the institution and results in shift delays. It also has a cost in terms of equipment performance: when operated by inexperienced personnel, it encourages breakage due to incorrect use. On the other hand, current standards prevent, from an ethical point of view, doctors in training from using patients for training. What is the reason that makes guardianship necessary? For the patient who is the object of the procedure, the procedure is unique and unrepeatable - in general - and should be performed in the best possible way. That event for the individual patient is in principle unique.

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