Objective evaluation of competence: technical skills in gastrointestinal endoscopy.

Documentation of an individual trainee's competence in gastrointestinal endoscopy has relied on the opinion of supervisors. Recommendations about the minimum number of procedures required to attain technical competence has relied on expert opinion. Recently, objective data about procedural competence have been collected. These data suggest that the mean number of procedures required to approach technical competence is higher than that recommended by experts. The data can be used to give a more accurate and objective evaluation of each trainee, as well as to develop objective guidelines about the minimum number of procedures to be accomplished during training. In addition, objective grading systems can be applied to other surgical and nonsurgical procedures.