Department of Gastroenterology, Dudley Group Hospitals NHS Foundation Trust, Dudley, United Kingdom.
Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, United Kingdom.
Endoscopy. 2018 Aug;50(8):770-778. doi: 10.1055/a-0576-6667. Epub 2018 Apr 3.
Direct Observation of Procedural Skills (DOPS) is an established competence assessment tool in endoscopy. In July 2016, the DOPS scoring format changed from a performance-based scale to a supervision-based scale. We aimed to evaluate the impact of changes to the DOPS scale format on the distribution of scores in novice trainees and on competence assessment.
We performed a prospective, multicenter (n = 276), observational study of formative DOPS assessments in endoscopy trainees with ≤ 100 lifetime procedures. DOPS were submitted in the 6-months before July 2016 (old scale) and after (new scale) for gastroscopy (n = 2998), sigmoidoscopy (n = 1310), colonoscopy (n = 3280), and polypectomy (n = 631). Scores for old and new DOPS were aligned to a 4-point scale and compared.
8219 DOPS (43 % new and 57 % old) submitted for 1300 trainees were analyzed. Compared with old DOPS, the use of the new DOPS was associated with greater utilization of the lowest score (2.4 % vs. 0.9 %; < 0.001), broader range of scores, and a reduction in competent scores (60.8 % vs. 86.9 %; < 0.001). The reduction in competent scores was evident on subgroup analysis across all procedure types ( < 0.001) and for each quartile of endoscopy experience. The new DOPS was superior in characterizing the endoscopy learning curve by demonstrating progression of competent scores across quartiles of procedural experience.
Endoscopy assessors applied a greater range of scores using the new DOPS scale based on degree of supervision in two cohorts of trainees matched for experience. Our study provides construct validity evidence in support of the new scale format.
直接观察操作技能（DOPS）是内镜检查中一种成熟的能力评估工具。2016 年 7 月，DOPS 的评分格式从基于表现的评分转变为基于监督的评分。我们旨在评估 DOPS 评分格式的变化对新手学员分数分布的影响以及对能力评估的影响。
我们进行了一项前瞻性、多中心（n=276）、形成性 DOPS 评估的观察性研究，评估对象为内镜操作经验≤100 例的学员。DOPS 在 2016 年 7 月之前（旧评分）和之后（新评分）的 6 个月内提交，用于胃镜检查（n=2998）、乙状结肠镜检查（n=1310）、结肠镜检查（n=3280）和息肉切除术（n=631）。将新旧 DOPS 的评分对齐到 4 分制并进行比较。
分析了 1300 名学员的 8219 份 DOPS（43%新评分，57%旧评分）。与旧 DOPS 相比，新 DOPS 的使用与最低评分（2.4%比 0.9%； <0.001）的更多使用、更广泛的评分范围以及更胜任评分的减少（60.8%比 86.9%； <0.001）有关。在所有程序类型（ <0.001）和内镜经验的每个四分位数中，胜任评分的减少都是明显的。新 DOPS 通过显示在操作经验四分位数中熟练评分的进展，在描绘内镜学习曲线方面表现更好。
在两个经验匹配的学员队列中，内镜评估者使用新的 DOPS 评分尺度根据监督程度应用了更广泛的评分范围。我们的研究提供了支持新评分格式的结构有效性证据。
