Authors: Nur-In Mohammad and Phedra Dodds

Learning points

1. Endoscopy is a rapidly evolving specialism with more complex and high-risk procedures being performed regularly. The workforce needs to be trained and educated to be confident and competent to assist during these procedures and to provide high quality care for patients throughout their journey
2. Effective clinical training involves dynamic, structured and standardised evidence-based programs that deliver educational material in accessible ways for staff e.g., e-learning, courses and competency frameworks
3. Training and Education opportunities are a contributing factor in the recruitment and retention of nurses and can be accessed nationally or regionally via multi-professional endoscopy academies

Key words

Endoscopy, Nurse, Education, Training, Academies,

Abbreviations

BSG British Society of Gastroenterology
CPD Continuing Professional Development
ELERT Endoscopy Life Threatening Events Recognition and Treatment
e-lfh E-learning for Health
JAG Joint Advisory Group on Gastrointestinal endoscopy
JETS JAG Endoscopy training scheme

Introduction

Endoscopy workforce education and training is multi-professional, mostly delivered within units by practice educators, mentors, peers, industry, assessors, and supervisors, is facilitated and developed by regional endoscopy academies and led by national organisations and programs such as those provided by the British Society of Gastroenterology (BSG) and the Joint Advisory Group on Gastro-intestinal endoscopy (JAG). Continuing professional development (CPD) is central to all staffs’ development and constitutes a vital aspect of updating knowledge and skills1. Endoscopy is a rapidly evolving and challenging specialty involving staff providing patient care and procedural assistance for an increasingly wide variety of complex diagnostic and therapeutic techniques2.Tailored endoscopy specific education and training is needed to improve recruitment, and the retention of competent and confident highly skilled staff and should be available to all endoscopy staff, irrespective of banding or tenure within the service3. The training should target personal, professional, and service development and facilitate improved patient care, evidence-based knowledge acquisition and a quality‐improvement culture4.

Education and training

Whether training and education is delivered locally within units, regionally by endoscopy academies or nationally via BSG or JAG programs, all require a dynamic, structured, standardised and evidence-based approach and the application of endoscopy specialty materials. Those delivering the education should have training in the delivery of the learning package and be recognised for their educational input e.g. be designated supervisor, assessors, mentors, or course faculty and given time within their job to provide high quality training.

Staff require different intensity, speed, and types of educational material at different stages of their endoscopy career. At induction, staff require an accelerated graduated program which builds upon an agreed learning plan to accredit their knowledge, practical skills, and endoscopic non-technical skills (ENTS) such as communication and team work5. Staff who are progressing their career or are experienced in endoscopy also need a variety of opportunities to gain evidence-based education to develop and update their skills and career. The aim of all training should be to reach competence and confidence6 in the skill practiced via application of knowledge, interpersonal skills, decision‐making, and psychomotor skills in practice.

The most effective training is multi-professional and has a package of different and complementary modes of provision, including theoretical evidence, reflective discussion and practical demonstration and use. Traditionally these delivery methods have included guided hands-on training with patients, clinical supervision and mentoring face to face courses, industry demonstrations, conferences, peer support, and visits to other units, additional newer methods include e-learning, simulation, virtual or augmented reality, podcasts, videos, and wet-lab based model work7.

Challenges

Time and funding constitute the biggest constraints to release of staff for education and training. Increasing demand for endoscopy, clinical complexity, COVID recovery8 and structural developments, coupled with widespread recruitment and retention difficulties, have reduced the ability of units to release staff for endoscopy specialty training, provide adequate in-house supervision or release staff as faculty for courses.

Support and Resources

Endoscopy Academies have been established and are maturing across the seven regions of England, with a national academy in Scotland and Wales. They play a key part in enabling multi-professional learning, innovation in education delivery, accelerated training and support workforce development. Examples of new workforce courses include the ELERT course (North West Endoscopy Academy), and the TENT course (Midlands and South West Endoscopy Training Academies) and widespread JAG JETS Workforce ENDO 1 face-to-face courses.

The JAG JETS Workforce9 provides a structured, standardised framework for the education and training of the endoscopy workforce via a tri-part programme comprised of e-learning modules, a competency framework, and training courses that progresses staff from foundation level, through an advanced level to management and leadership. The foundation level e-learning for health modules and ENDO 1 course have now been included within the JAG Accreditation Standards 2023, and units are now mandated to release a percentage of staff for this training to secure or retain their JAG accreditation.

The BSG offers and endorses courses and conferences10 for its members including hands on immersive experiential training via EndoVillage at BSG LIVE.

Endoscopy Practice Educators are becoming widespread within units, and provide clinical training within units, roles as supervisors and assessors and act as faculty on regional and national courses, establish training programs, liaise with industry and crucially support and nurture staff.

Conclusion

Endoscopy workforce education and training has, in recent years, increased in variety, developed in depth and breadth, and become enriched in content, delivery and spread, but more needs to be done to ensure equity of training provision for all Endoscopy staff and for organisational cultures to support education.

Author Biographies