P118 Challenges and lessons from an evaluation of the national clinical endoscopist training programme in Wales

Introduction

There is a UK-wide need to increase the number of Clinical Endoscopists (CEs). From April 2019 CEs were recruited to an accelerated programme of training (small group teaching, Masters level modules; simulation; JAG courses; training lists; and on-line courses & tutorial groups) – to achieve JAG accreditation.

Methods

We conducted quantitative & qualitative evaluation mapped to a logic model (1) of the impact of the training. We combined evidence from literature review, observation, surveys and interviews with trainees, trainers & mentors; discussion with course leaders; data from the Cognitive Load Inventory for Colonoscopy (CLIC) survey (2) and review of programme outcome data.

Results

Ten trainees in two cohorts were evaluated – six completed all elements of training, three are still in training (redeployed due to COVID). Thematic analysis highlighted eight areas: technical skills, non-technical skills, the programme, academic elements, training units, trainers, personal qualities, and career development. All trainees reported acquiring technical skills enabling them to undertake procedures safely. Trainees reported significant highs and lows. Older trainees and those with experience of working in endoscopy units reported less cognitive load. Non-technical skills took longer but leading the team or writing reports with support from tutors were helpful in overcoming anxieties. Trainees valued the structure the programme provided – structured handbooks and parallel training for independent prescribing would have added value. Good clinical and senior nurse support correlated with good progression. Trainees described barriers of professional jealousy, no identified trainer or training list, or lack of senior support. COVID-19 was a factor. Trainers identified the resilience, resourcefulness and negotiating as key skills and felt they could identify applicants most likely to succeed. Trainees were motivated to take on the role but needed help and support if training had not gone well.

Conclusion

The journey taken by CEs to acquire the skills required for advanced practice roles tests a wide range of knowledge, motor, and professional skills. Developing the crucial critical thinking and cognitive skills must develop alongside mental resilience, and requires support from course tutors, optimally designed course elements, access to training lists and supportive local teams.

References

Baxter SK et al, BMC Med Res Methodol 14,62 (2014) Sewell JK et al, Medical Education 2013;50: 682-692