Training In Gastrointestinal Endoscopy Research Articles

Role of Virtual Reality in Gastrointestinal Endoscopy Training and Teaching

Gastrointestinal (GI) endoscope is one of the instruments used extensively in the diagnosis and treatment of digestive tract disorders. China is confronted with a great demand for endoscopists working in grassroots healthcare facilities. Furthermore, endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography (EUS), and endoscopic submucosal dissection (ESD) are becoming the prevailing methods of endoscopic treatment of digestive diseases. Therefore, there is a growing demand for senior endoscopists. Currently, an important focus of GI endoscopy training is the acceleration of standardized training for endoscopists working in grassroots health facilities and advanced training for senior endoscopists. Simulation devices based on virtual reality technology exhibit strengths in objectivity, authenticity, and an immersive experience. These devices show advantages in the training method, the number of participants, and assessment over traditional training programs for GI endoscopy. Their application provides a new approach to the training and teaching of GI endoscopy. Herein, we summarized the explorations and practices of using virtual reality technology in the training and teaching of GI endoscopy, analyzed its application status in China, and discussed its prospects for future application.

Training in basic gastrointestinal endoscopic procedures: a European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement.

This ESGE Position Statement provides structured and evidence-based guidance on the essential requirements and processes involved in training in basic gastrointestinal (GI) endoscopic procedures. The document outlines definitions; competencies required, and means to their assessment and maintenance; the structure and requirements of training programs; patient safety and medicolegal issues. 1: ESGE and ESGENA define basic endoscopic procedures as those procedures that are commonly indicated, generally accessible, and expected to be mastered (technically and cognitively) by the end of any core training program in gastrointestinal endoscopy. 2: ESGE and ESGENA consider the following as basic endoscopic procedures: diagnostic upper and lower GI endoscopy, as well as a limited range of interventions such as: tissue acquisition via cold biopsy forceps, polypectomy for lesions ≤ 10 mm, hemostasis techniques, enteral feeding tube placement, foreign body retrieval, dilation of simple esophageal strictures, and India ink tattooing of lesion location. 3: ESGE and ESGENA recommend that training in GI endoscopy should be subject to stringent formal requirements that ensure all ESGE key performance indicators (KPIs) are met. 4: Training in basic endoscopic procedures is a complex process and includes the development and acquisition of cognitive, technical/motor, and integrative skills. Therefore, ESGE and ESGENA recommend the use of validated tools to track the development of skills and assess competence. 5: ESGE and ESGENA recommend incorporating a multimodal approach to evaluating competence in basic GI endoscopic procedures, including procedural thresholds and the measurement and documentation of established ESGE KPIs. 7: ESGE and ESGENA recommend the continuous monitoring of ESGE KPIs during GI endoscopy training to ensure the trainee's maintenance of competence. 9: ESGE and ESGENA recommend that GI endoscopy training units fulfil the ESGE KPIs for endoscopy units and, furthermore, be capable of providing the dedicated personnel, infrastructure, and sufficient case volume required for successful training within a structured training program. 10: ESGE and ESGENA recommend that trainers in basic GI endoscopic procedures should be endoscopists with formal educational training in the teaching of endoscopy, which allows them to successfully and safely teach trainees.

Needs assessment of basic gastrointestinal endoscopy training: A qualitative study in Indonesia.

Gastointestinal endoscopy is a complex practical skill, and training and experience are required to ensure the accuracy and safety of the procedures. Therefore, proper endoscopy training is needed to provide highly skilled endoscopists. This study explores the learning experience and assesses the need for endoscopy training in Indonesia from an endoscopy trainee's point of view. Limitations from the current training model and the trainees' suggestions hopefully will become a foundation for the future endoscopy training model in Indonesia. A total of 132 current endoscopy trainees and graduates of endoscopy training from various centers in Indonesia completed an online qualitative survey regarding their endoscopy training experience, their satisfaction with the current training method, barriers to achieving competency, and their suggestions for future training. Data were subjected to descriptive and qualitative analysis using content analysis. We found variations in the trainee's learning experience regarding the training supervision, feedback, and assessment methods. The most common endoscopy training methods were observation and direct practice with supervision. There was only a low proportion of simulator use (25%). The most found concept in barriers to achieving competency was "insufficient number of patients." Meanwhile, the most found concept in suggestions for future training methods was "increasing the variety of cases and procedures." Our findings suggest that there are still variations in endoscopy training methods in Indonesia. Therefore, we propose to design a standardized endoscopy training program to ensure the competence of endoscopy trainees and better care for endoscopic patients. Simulators might be used to increase the trainees' competence in settings with low numbers of patients or cases.

Training in Pediatric Gastrointestinal Endoscopy during Surgery Residency: Can Training Programs Currently Educate Proficient Pediatric Endoscopists? A Nationwide Assessment

Background: Technological advances in pediatric gastrointestinal (GI) endoscopy require highly specialized physicians. Therefore, proper training is fundamental. The aim of this study was to assess the level of competence of pediatric surgery residents to determine areas that should be addressed to design better training programs focused on pediatric GI endoscopy. Methods: An observational study was performed on all Italian pediatric surgery trainees that concluded the training program by the end of 2021, who were asked to answer a questionnaire about the quality of the GI endoscopy education received during their 5 years of residency. Results: 12 out 14 (86%) pediatric surgery trainees answered the questionnaire. A total of 50% (6/12) of the trainees declared they were interested in pediatric GI endoscopy, and 42% (5/12) said that they would be interested in dedicating themselves to this discipline in the future. Only 33% (4/12) of them were in a center equipped with endoscopy simulators. Among them, 17% (2/12) never took part in GI endoscopic procedures while working in centers in which GI endoscopy is performed exclusively by pediatric gastroenterologists, 25% (3/12) had never performed GI endoscopic procedures as a first operator and 17% (2/12) not even as assistant. Overall, 50% (6/12) were not satisfied with the level of education received and only 17% (2/12) declared that they felt confident enough to perform routine endoscopies alone. Conclusions: Our study highlights great inhomogeneity between different schools and some important failings. Better programs should be designed to educate proficient pediatric GI endoscopists.

Remote training and teleproctoring in gastrointestinal endoscopy for practicing surgeon in rural Uganda.

There is a significant, unmet need for endoscopy services in rural Uganda. With limited diagnostic and therapeutic interventions, patients in these communities often present with advanced disease. Practicing surgeons must continually adapt to new techniques to meet the needs of their patient populations. Here, we present a remotely proctored endoscopy training program for a surgeon practicing in an area devoid of endoscopic capabilities. This was a retrospective case series conducted between February 2020 and December 2022 at Kyabirwa Surgical Center (KSC). After a 1-week in-person training camp, one surgeon performed endoscopy under guidance of a remote proctor. Patient data and outcomes were collected retrospectively. The previously endoscopic naïve practicing Ugandan surgeon was remotely proctored for 139 endoscopic cases and he subsequently independently performed 167 diagnostic colonoscopies and 425 upper endoscopies. Therapeutic endoscopy was conducted under remote guidance after proficiency in diagnostic endoscopy. A total of 43 therapeutic procedures were performed, including 29 esophageal stent placements, 5 variceal bandings, and 9 foreign body retrievals. All procedures were completed without complication. Our center developed a remotely proctored endoscopy program that allowed for training of practicing surgeons in an area lacking endoscopic services. Despite its limitations, remotely proctored endoscopy serves as a unique but highly valuable method of expanding access to endoscopy, particularly in areas that lack adequate training opportunities.

The rise of the simulator-based training method in gastrointestinal endoscopy training and currently available simulators.

The apprenticeship-based training method (ABTM) is highly effective for gastrointestinal (GI) endoscopic training. However, the conventional ABTM has significant issues. Although many supplementary training methods (TMs) have been developed and utilized, they cannot entirely replace the ABTM, which remains the major TM strategy. Currently, new TM construction is crucial and necessary due to financial constraints, difficulty of obtaining sufficient training time due to patient safety-related regulations, and catastrophic damage caused by disasters such as the coronavirus disease 2019 pandemic. The simulator-based TM (SBTM) is widely accepted as an alternative to the ABTM, owing to the SBTM's advantages. Since the 1960s, many GI endoscopy training simulators have been developed and numerous studies have been published on their effectiveness. While previous studies have focused on the simulator's validity, this review focused on the accessibility of simulators that were introduced by the end of 2021. Although the current SBTM is effective in GI endoscopic education, extensive improvements are needed to replace the ABTM. Incorporating simulator-incorporated TMs into an improved ABTM is an attempt to overcome the incompleteness of the current SBTM. Until a new simulator is developed to replace the ABTM, it is desirable to operate a simulator-integrated and well-coordinated TM that is suitable for each country and institution.

Training and competence in Digestive Endoscopy: Statement Position Paper from the Spanish Society of Digestive Diseases.

Gastrointestinal (GI) Endoscopy is a basic competence for the management of gastrointestinal diseases. However, it should not be regarded as an independent training technique. Rather it is a part of a continuous and accredited process that requires clinical knowledge from the gastroenterologist to keep skills up-to-date in a constantly evolving medical subspecialty. Thus, the only official accredited way for training in GI endoscopy is through the Specialized Health Training program in the Management of the Digestive Diseases administered by the Spanish Ministry of Health.

A 2-week intensive gastrointestinal endoscopy training program for pediatricians.

In Japan there are limited opportunities for pediatricians to learn gastrointestinal (GI) endoscopy. This study investigated whether a short-term intensive training for 2 weeks in an adult GI setting enabled pediatricians to acquire basic technical competence for pediatric GI endoscopic procedures. This was a retrospective case series of pediatricians who underwent 2 weeks of intensive endoscopy training at an adult endoscopy unit in a community hospital. The numbers of esophagogastroduodenoscopy (EGD) and ileocolonoscopy procedures each pediatrician performed were evaluated. All enrolled pediatricians were asked to answer questionnaires regarding the 2 week intensive GI endoscopy training program. There were 17 enrolled pediatricians, of whom 13 were men; average age 32 years (range 27-54). The median (range) numbers of EGDs and ileocolonoscopies performed by each pediatrician during the 2-week training period were 102 (66-144) and 14 (1-48), respectively. Fifteen out of 17 pediatricians experienced more than 100 GI endoscopies during the 2 weeks. All pediatricians performed biopsies as part of some EGD procedures. All 17 pediatricians found this program satisfactory. All pediatricians became cable of performing pediatric EGD (i.e., for children ≤15 years) after this training program. Sixteen pediatricians have continued to perform pediatric GI endoscopy since this training program. A short-term intensive training program for 2 weeks in an adult GI setting enabled pediatricians to acquire basic technical competence for pediatric endoscopic procedures.

Impact of the Coronavirus Disease 2019 Pandemic on Pediatric Gastrointestinal Endoscopy: A Questionnaire-based Internet Survey of 162 Institutional Experiences in Asia Pacific.

The impact of coronavirus 2019 (COVID-19) on gastrointestinal (GI) endoscopy procedures in adults has been reported, with a drastic reduction in the number of procedures. However, there are no sufficient data regarding the impact on pediatric GI endoscopy. Here, we aimed to report that impact in the Asia-Pacific region. A questionnaire-based internet survey was conducted from June to November 2021 among pediatric endoscopy institutions in the Asia-Pacific region, with each institution providing a single response. Overall, 25 questions focused on the impact of the number of procedures conducted, the usage of personal protective equipment (PPE), and endoscopy training programs during the pandemic. A total of 162 institutions across 13 countries in the Asia-Pacific region participated in the study, and 133 (82.1%) institutions underwent procedure changes since the emergence of COVID-19. The number of esophagogastroduodenoscopy and ileocolonoscopy procedures decreased in 118/133 (88.7%) and 112/133 (84.2%) institutions, respectively. Endoscopy for patient with positive COVID-19 in an emergency or urgent cases still carried out in 102/162 (62.9%) institutions. Screening of COVID-19 for all patients before endoscopy was done across 110/162 (67.9%) institutions. PPE recommendations varied among institutions. Pediatric gastrointestinal endoscopy training programs were discontinued in 127/162 (78.4%) institutions. This study reports the impact of the COVID-19 pandemic on pediatric gastrointestinal endoscopy in the Asia-Pacific region. There has been a significant reduction in the number of endoscopic procedures and relevant training programs.

Endoscopy training in the Netherlands: a national survey among gastroenterology residents.

Background and study aims Training in endoscopy is a key objective of gastroenterology residency. There is currently no standardized or systematic training approach. This study evaluated and compared the current status of gastrointestinal endoscopy training programs in all teaching hospitals in the Netherlands from a resident perspective. Materials and methods A national online survey with open and closed questions on gastrointestinal endoscopy training was administered to all gastroenterology residents (N = 180) in the eight educational regions in the Netherlands. Results One hundred residents who had already started endoscopy training were included in the analyses. Sixty-five residents (65 %) were satisfied with their endoscopy training program. Participation in a preclinical endoscopy course was mandatory in seven of eight educational regions. Residents from the region without a mandatory endoscopy training course were significantly less likely to be satisfied with their endoscopy training program (32 %, P = .011). Criteria used to determine the level of supervision differed greatly between teaching hospitals (e. g. assessed endoscopy competence, predefined period of time or number of procedures). Only 26 residents (26 %) reported uniformity in teaching methods and styles between different supervising gastroenterologists in their teaching hospital. Conclusions Although most gastroenterology residents were satisfied with the endoscopy training program and endoscopy supervision in their teaching hospital, this study identified considerable local and regional variability. Future studies should be conducted to evaluate the trainers' perspective and trainers' behavior during endoscopy training sessions, which might eventually lead to the development of best practices regarding endoscopy training, including standardization of training programs and supervision methods.

Simulation-based mastery learning in gastrointestinal endoscopy training.

Simulation-based mastery learning (SBML) is an emerging form of competency-based training that has been proposed as the next standard method for procedural task training, including that in gastrointestinal endoscopy. Current basic gastrointestinal endoscopy training relies on the number of procedures performed, and it has been criticized for its lack of objective standards that result in variable skills among trainees and its association with patient safety risk. Thus, incorporating simulators into a competency-based curriculum seems ideal for gastrointestinal endoscopy training. The curriculum for SBML in gastrointestinal endoscopy is currently being developed and has promising potential to translate into the clinical performance. Unlike the present apprenticeship model of “see one, do one, teach one,” SBML integrates a competency-based curriculum with specific learning objectives alongside simulation-based training. This allows trainees to practice essential skills repeatedly, receive feedback from experts, and gradually develop their abilities to achieve mastery. Moreover, trainees and trainers need to understand the learning targets of the program so that trainees can focus their learning on the necessary skills and trainers can provide structured feedback based on the expected outcomes. In addition to learning targets, an assessment plan is essential to provide trainees with future directions for their improvement and ensure patient safety by issuing a passing standard. Finally, the SBML program should be planned and managed by a specific team and conducted within a developed and tested curriculum. This review discusses the current state of gastrointestinal endoscopy training and the role of SBML in that field.

Hospital compound-level endoscopy training quality performance: scoping the spectrum.

Background and study aims This study aimed to assess the quality of endoscopy training in a UK Statutory Educational Body compared with Joint Advisory Group on Gastrointestinal Endoscopy Training standards (JETS). Methods A total of 28,298 training procedures recorded by 211 consecutive cross-specialty trainee endoscopists registered with JETS in 18 hospitals during 2019 were analyzed. Data included trainer and trainee numbers, training list frequency, procedures, direct observation of procedural skills (DOPS) completion, and key performance indicators. Results Annual median training procedures per hospital were 1395 (interquartile range (IQR) 465–2365). Median trainers and trainees per unit were 11 (6–18) and 12 (7–16), respectively, (ratio 0.8 [0.7–1.3]). Annual training list frequency per trainee was 13 (10–17), 35.0 % short of Joint Advisory Group (JAG) standard (n = 20, P = 0.001, effect size –0.56). Median points per adjusted training list were 11 (5–18). Median DOPS per trainee and trainer were three (1–6) and four (1–7) respectively; completing 0.2 DOPS (0.1–0.4) per list and amounting to six (2–12) per 200 procedures: fewer than half of the JAG standard (20 per 200) (P < 0.001, –0.61). Esophagogastroduodenoscopy median KPI: J maneuver 94 % (90–96), D2 intubation 93 % (91–96); Colonoscopy KPI: cecal intubation 82 % (72–90), polyp detection rate 25 % (18–34). Compound hospital score ranged from nine to 26 (median 17 [14–20]). Conclusions Important performance disparity emerged with three-fold variation in compound hospital training quality and most units underperforming compared with JAG standards. Trainees and training program directors should be aware of such metrics to improve quality endoscopy educational programs and consider formal adjuncts to optimize training.

Educación virtual y simulación en endoscopía

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.

The Distribution and Composition of Colonoscopy Providers in Australia

Introduction: Colorectal cancer is a common cause of cancer in Australia. Also, patients living in regional and rural areas are diagnosed later and have poorer outcomes compared to their metropolitan counterparts. The purpose of this study is to determine the distribution of the workforce providing colonoscopies for the Australian population.Methods: A cross-sectional observational study of the medical practitioners certified by the conjoint committee for the recognition of training in gastrointestinal endoscopy (CCRTGE) was performed. Data regarding their specialty and principal place of practice was collected. The principal place of practice was stratified with the Modified Monash Model (MMM) of rurality and the local government association’s classifications of rural and urban areas.Results: As of March 2021, there were 2698 medical practitioners listed as being recognised in the field of adult colonoscopies by the CCRTGE. Of these, 2123 were found to still have active specialist registration with the Australian Health Practitioner Regulation Agency (AHPRA). In the capital city Local Government Areas (LGAs), there was an endoscopist every 0.33 km2 to 62.05 km2. In the rural LGAs, there was an endoscopist every 23,382 km2 to 267,780 km2. In metropolitan areas, the most common specialty of the endoscopist was gastroenterology whereas in regional cities and remote towns it was general surgery. In very remote towns, general practitioners provided colonoscopy services.

Development of a list of minimum procedures for certifying competence in gastrointestinal endoscopy by the Delphi method.

within the frame of reference of any medical specialty, having a consensus list of the type and number of practices characterizing its professional work is key. Thus, the goal of this study was to define a list of minimum procedures to ensure competence in gastrointestinal endoscopy based on a structured consensus process, and to explore the views of leading experts in gastrointestinal endoscopy regarding endoscopist training in Argentina and the need for competence certification. this research entailed a mixed-methods prospective study including using the Delphi method as focus group qualitative research technique, followed by a structured survey. the final consolidated list included 17 procedures deemed essential for competence certification in gastrointestinal endoscopy. Given the dispersion found in the range of minimum numbers required for competence a decision was made to use the median value. For upper gastrointestinal endoscopy the minimum number of procedures was set at 200, whereas 150 was established for videocolonoscopy. this list is a key item in the development of a gastrointestinal endoscopy training framework and competence certification program.

Short‐term intensive gastrointestinal endoscopy training program

AbstractBackgroundIn Japan there are limited opportunities for pediatric gastrointestinal (GI) trainees to learn GI endoscopy. This study investigated whether a short‐term intensive training for 3 months in an adult GI unit enabled pediatric GI trainees to acquire the required number of cases and the technical competence to perform pediatric GI endoscopic procedures.MethodsThis was a retrospective case series of pediatric GI trainees who underwent 3 months of intensive endoscopy training, which also included direct observation and a questionnaire. The numbers of esophagogastroduodenoscopies (EGD), ileocolonoscopies, and snare polypectomies each trainee performed as well as cecal intubation rates were collected with the goal of meeting the standards of overseas educational guidelines. The trainees were also asked about continuing experience with pediatric endoscopic procedures after the intensive training.ResultsThere were 10 enrolled trainees, 9 men, average age, 34 (range, 29–41). The average number (range) of EGD and ileocolonoscopies that the 10 trainees had done before this training period was 52 (0–200) and 15 (0–20), respectively. The average number (range) of EGD, ileocolonoscopies and snare polypectomies per each trainee was 651.7 (485–814), 159.2 (130–195) and 25.8 (10–55), respectively, over 3 months: all trainees thus fulfilled all of the criteria of the minimal training requirements. All trainees also reached the required threshold in the cecal intubation rate (&gt;90%). In addition, all trainees were able to perform pediatric endoscopic procedures alone after the intensive training period.ConclusionsShort‐term intensive training for 3 months in an adult GI setting enabled pediatric GI trainees to acquire technical competence for pediatric endoscopic procedures.

SP2.2.16Hospital compound level endoscopy training quality performance: scoping the spectrum

Abstract Aims This study aimed to assess the quality of endoscopy training in a single UK Statutory Educational Body (SEB), related to individual hospitals,compared with the Joint Advisory Group on Gastrointestinal Endoscopy Training (JETS) certification standards. Methods Training procedures numbering 28,928 recorded by 211 consecutive cross-specialty trainee endoscopists registered with JETS in18 hospitals during 2019were analysed. Data included trainer and trainee numbers, training list frequency, procedures, Direct Observation of Procedural Skills (DOPS) completion and Key Performance Indicators (KPI). Results Annual median training procedures per hospital were 1395 (interquartile range (IQR) 465-2365). Median (IQR) trainers and trainees per unit were 11 (6-18) and 12 (7-16) respectively (ratio 0.8 (0.7-1.3)). Annual training list frequency per trainee was 13 (10-17), 35.0% short of JAG standard (n = 20, p = 0.001, effect size -0.56), and median points per adjusted training list were 11 (5-18). Median DOPS completion per trainee and trainer were 3 (1-6) and 4 (1-7) respectively; completing 0.2 DOPS (0.1-0.4) per list and amounting to 6 (2-12) per 200 procedures: less than half of the JAG standard (p &amp;lt; 0.001, -0.61). Median KPI for OGD: J Manoeuvre 94% (90-96), D2 intubation was 93% (91-96); and for Colonoscopy: Caecal intubation 82% (72-90), and Polyp Detection Rate 25% (18-34). Compound hospital training quality score varied 3-fold, the highest performing hospital scoring 26; compared to the poorest performing scoring 9: median 17 (14-20). Conclusion Important variation in endoscopy unit performance were apparent with compound hospital training quality varying almost 3-fold. Trainees, Training Programme Directors alike, should be aware of such data when planning educational programmes to focus, optimise the quality of endoscopic training.

Remote training in flexible gastrointestinal endoscopy.

Video 1Remote training in flexible GI endoscopy.

Enhancing the learning and supervision framework for training in flexible endoscopic evaluation of swallowing.

This article reviews the literature on the development of competency-based training and assessment in endoscopy, comparing gastrointestinal endoscopy and flexible endoscopic evaluation of swallowing (FEES). The discussion focusses on how a robust and explicit learning framework can be translated to the delivery of training in FEES to optimize trainee outcomes and supervisor skill. Specialist Speech and Language Therapists (SLT) carry out FEES to inform the diagnosis and management of swallowing and voice disorders. Taught courses are generally followed by local workplace-based supervised practice to attain the competencies identified in the relevant professional guidelines. However, the curriculum for the workplace-based FEES training lacks a learning and assessment framework and little direction for the workplace-based supervisor. In gastrointestinal endoscopy training, this previously led to less than optimal outcomes for trainees and patients and so new models of training were developed. A new learning framework for FEES underpinned by medical pedagogy has shown early promise in supporting the acquisition of competence. Incorporating a new FEES-specific systematic assessment, the framework provides direction for the supervisor and evidence of trainee progression, which subsequently enhances supervisor confidence to determine trainee competence.

Adult Gastroenterology Trainees’ Experience of Receiving Feedback on Their Performance of Endoscopy in the Workplace

BackgroundCompetency-based gastrointestinal endoscopy training is concerned with outcomes of the learning experience. Feedback allows for trainees to achieve the expected outcomes. However, little is known about trainees’ experience of receiving feedback. Gaining understanding of their experience could help improve feedback practices. The study was conducted to explore what it means for adult gastroenterology trainees to receive feedback on their performance of endoscopy in the workplace.MethodsAn interpretative phenomenological approach was used. Individual semi-structured interviews were conducted with six trainees from three Canadian adult gastroenterology residency programs. Interviews were audio-recorded and transcribed verbatim for analysis. Analysis was conducted to identify the phenomenological themes across participants’ accounts of lived experience to provide an insight into the meaning of experiencing the studied phenomenon.FindingsThree phenomenological themes of experience were identified: taking pauses, negotiating understandings and accepting asymmetry. Taking pauses allowed for participants to receive feedback on their performance of endoscopy. Participants needed to negotiate attending gastroenterologists’ different understandings of gastrointestinal endoscopy while carrying their own whenever feedback was provided. They had to accept the asymmetry between the roles of care provider and learner as well.DiscussionThe study has captured the uniqueness and the complexity of the lived experience of receiving feedback on the performance of endoscopy in the workplace from the perspective of study participants. The gained understanding of this experience has enabled the authors to suggest how attending gastroenterologists’ feedback practices may be improved.