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World J Gastrointest Endosc. Apr 16, 2010; 2(4): 112-120
Published online Apr 16, 2010. doi: 10.4253/wjge.v2.i4.112
Is the ‘driving test’ a robust quality indicator of colonoscopy performance?
Nicholas M Kelly, John Moorehead, Tony Tham
Nicholas M Kelly, Tony Tham, Division of Gastroenterology, Ulster Hospital, Belfast, BT16 1RH, United Kingdom
John Moorehead, Department of Surgery, Ulster Hospital, Belfast, BT16 1RH, United Kingdom
Author contributions: This article was conceived and planned by Tham T, Moorehead J and Kelly NM. Kelly NM wrote the first draft. All the authors contributed to the subsequent revisions.
Correspondence to: Nicholas M Kelly, MB, BCH, BAO, MRCP, Department of Gastroenterology, Ulster Hospital, Belfast, BT16 1RH, United Kingdom.
Telephone: +44-28-90561344 Fax: +44-28-90561396
Received: July 23, 2009
Revised: March 27, 2010
Accepted: April 3, 2010
Published online: April 16, 2010

Colorectal cancer is a major cause of death in the western world and is currently the second commonest cause of death from malignant disease in the UK. Recently a “driving test” for colonoscopists wishing to take part in the National Health Service Bowel Cancer Screening Program has been introduced, with the aim of improving quality in colonoscopy. We describe the accreditation process and have reviewed the published evidence for its use. We compared this method of assessment to what occurs in other developed countries. To the authors’ knowledge no other countries have similar methods of assessment of practicing colonoscopists, and instead use critical evaluation of key quality criteria. The UK appears to have one of the most rigorous accreditation processes, although this still has flaws. The published evidence suggests that the written part of the accreditation is not a good discriminating test and it needs to be improved or abandoned. Further work is needed on the best methods of assessing polypectomy skills. Rigorous systems need to be in place for the colonoscopist who fails the assessment.

Keywords: Colonoscopy, Accreditation, Credentialing, Training, Bowel cancer, Screening, Colorectal cancer, Polyp, Caecum, Directly observed procedural skill