The future of gastroenterology training: instruction in technical skills.

Endoscopy training has developed extensively over the past decade but despite significant improvements many challenges remain and further development of endoscopy training programmes and content is required. Endoscopy training is struggling with increasing pressure from service provision and competition for limited National Health Service (NHS) resources. There is a rapidly increasing proportion of work shifting from diagnostic to therapeutic practice in the face of limited dedicated therapeutic training provision. In addition, there is a need to align quality assurance outcomes related to endoscopic practice with the key NHS quality indicators of patient experience, clinical effectiveness and safety. A vision for the future of endoscopy training is presented focusing on the need to target training resources most effectively and developing technical skills training in parallel to non-technical skills training (eg, effective decision making, communication and teamwork). Proposals for specialist technical skills training, future information technology systems and quality assurance framework integration are developed. The need to challenge some existing culture and behaviours is explained along with a challenge to embed a life-long learning approach in endoscopy training. Endoscopy training developments aim to ensure a high quality assured endoscopy service for all patients, where a skilled workforce can be provided to meet rising demand and changing technical skills requirements.