Open Access
CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(02): E324-E331
DOI: 10.1055/a-2161-1982
Original article

The Bethesda ERCP Skills Assessment Tool (BESAT) can reliably differentiate endoscopists of different experience levels

Authors

  • Kevin Liu

    1   Gastroenterology, Banner - University Medical Center Phoenix, Phoenix, United States (Ringgold ID: RIN22386)
  • B. Joseph Elmunzer

    2   Division of Gastroenterology, Medical University of South Carolina, Charleston, United States
  • Sachin Wani

    3   Gastroenterology, University of Colorado and Veterans Affairs Medical Center, Aurora, United States
  • Tiffany Taft

    4   Division of Gastroenterology, Northwestern University Feinberg School of Medicine, Chicago, United States
  • Catharine M Walsh

    5   Division of Gastroenterology, Hepatology, and Nutrition and the Research and Learning Institutes, The Hospital for Sick Children, Toronto, Canada (Ringgold ID: RIN7979)
    6   Department of Pediatrics, University of Toronto Faculty of Medicine, Toronto, Canada (Ringgold ID: RIN12366)
    7   The Wilson Centre, University of Toronto, Toronto, Canada
  • Mustafa A Arain

    8   Center for Interventional Endoscopy, AdventHealth Orlando, Orlando, United States (Ringgold ID: RIN440172)
  • Tyler M. Berzin

    9   Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, United States
  • James Buxbaum

    10   Medicine/Gastroenterology, University of California, San Francisco, San Francisco, United States
  • Christopher DiMaio

    11   Gastroenterology, Catholic Health St Francis Hospital & Heart Center, Roslyn, United States (Ringgold ID: RIN22471)
  • Syed M. Abbas Fehmi

    12   Internal Medicine, UC San Diego Health System, San Diego, United States
  • Neil Gupta

    13   Gastroenterology, Loyola University Medical Center, Chicago, United States (Ringgold ID: RIN25815)
  • Sreenivasa Jonnalagadda

    14   Gastroenterology, Saint Luke's Health System, Kansas City, United States (Ringgold ID: RIN14414)
  • Vladimir Kushnir

    15   Gastroenterology, Washington University, St Louis, United States
  • John T. Maple

    16   Internal Medicine, University of Oklahoma, Oklahoma City, United States
  • Raman Muthusamy

    17   Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, United States
  • Amit Rastogi

    18   Gastroenterology, Kansas University Medical Center, Kansas City, United States
    19   Gastroenterology, Veterans Affairs Medical Center, Kansas City, United States
  • Janak N Shah

    20   Gastroenterology, Ochsner Medical Center - New Orleans, New Orleans, United States (Ringgold ID: RIN81796)
  • Amitabh Chak

    21   Gastroenterology, UH Cleveland Medical Center, Cleveland, United States (Ringgold ID: RIN114516)
  • Ashley Faulx

    21   Gastroenterology, UH Cleveland Medical Center, Cleveland, United States (Ringgold ID: RIN114516)
  • Nauzer Forbes

    22   Medicine, University of Calgary, Calgary, Canada
  • Rajesh N Keswani

    23   Medicine, Northwestern University Feinberg School of Medicine, Chicago, United States (Ringgold ID: RIN12244)
Preview

Abstract

Background and study aims The Bethesda ERCP Skill Assessment Tool (BESAT) is a video-based assessment tool of technical endoscopic retrograde cholangiopancreatography (ERCP) skill with previously established validity evidence. We aimed to assess the discriminative validity of the BESAT in differentiating ERCP skill levels.

Methods Twelve experienced ERCP practitioners from tertiary academic centers were asked to blindly rate 43 ERCP videos using the BESAT. ERCP videos consisted of native biliary cannulation and sphincterotomy and were recorded from 10 unique endoscopists of various ERCP experience (from advanced endoscopy fellow to > 10 years of ERCP experience). Inter-rater reliability, discriminative validity, and internal structure validity were subsequently assessed.

Results The BESAT was found to reliably differentiate between endoscopists of varying levels of ERCP experience with experienced ERCPists scoring higher than novice ERCPists in 11 of 13 (85%) instrument items. Inter-rater reliability for BESAT items ranged from good to excellent (intraclass correlation range: 0.86 to 0.93). Internal structure validity was assessed with item-total correlations ranging from 0.53 to 0.83.

Conclusions Study findings demonstrate that the BESAT, a video-based ERCP skill assessment tool, has high inter-rater reliability and has discriminative validity in differentiating novice from expert ERCP skill. Further investigations are needed to determine the role of video-based assessment in improving trainee learning curves and patient outcomes.



Publikationsverlauf

Eingereicht: 20. März 2023

Angenommen nach Revision: 22. August 2023

Accepted Manuscript online:
28. August 2023

Artikel online veröffentlicht:
28. Februar 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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