Identifying Behaviors and Characteristics of High Quality Endoscopy Educators: Do We Practice What We Preach?

Abstract

Introduction: Teaching endoscopy requires a structured approach that encompasses cognitive and technical skills. Endoscopy education in the US traditionally follows the apprenticeship model, creating a wide variability in teaching techniques without clear guidance for best practices. Despite a growing appreciation of the need for endoscopy educators (EE) to be formally trained to teach procedures using evidence-based principles, there are limited data on which teaching behaviors are most important. Furthermore, there is no validated, objective way of assessing the quality of endoscopy education. Methods: After a literature review, we compiled a list of nine behaviors and characteristics of EE considered critical for effective teaching. Using Qualtrics, we electronically surveyed EE across the US to rate the importance of these behaviors and estimate how frequently they actually perform these behaviors while teaching. Results: The survey was sent to 258 EE in the US. The overall response rate was 19%. Respondent demographics are listed in Table 1. Educational behaviors were rated in importance on a scale from 1 (not important) to 6 (extremely important). The frequency of performance of behaviors was rated on a scale from 1 (never) to 5 (always). Results and correlation between importance and frequency is displayed in Table 2. All behaviors showed significant correlation between importance and frequency, but four behaviors showed only a medium-sized correlation (correlation coefficient 0.3-0.5). Conclusion: All teaching behaviors identified on our list were rated as at least “moderately important” by the respondents, with the most important behavior using clear, concise verbal instructions when needed. Our survey indicates that respondents “practiced what they preached”, although for 4 behaviors there was only a medium-sized correlation between importance and frequency. A potential area for improvement would be reviewing procedure notes with trainees, a behavior that was rated as at least “very important” by 75.5% of respondents but was done at least “most of the time” by only 48.6%. While our response rate of 19% raises the risk of nonresponse bias, prior studies have shown similar response rates among physician populations. Future directions for research includes developing an instrument to objectively assess endoscopy teaching quality and applying this instrument to measure the impact of interventions aimed at improving endoscopy teaching skills.495_A Figure 1. Respondent characteristics495_B Figure 2. Relative importance and frequency of endoscopy education behaviors