(1101) Assessing Competency in Transnasal Oesophagoscopy: A Scoping Review

Introduction: The value of trans-nasal oesophagoscopy (TNO/TNE) lies in our ability to use it as a tool to rapidly diagnose and treat ambulatory outpatients without operating theatre or endoscopy suite admission.

Methods: PRISMA-SCr was used. Data were extracted from Medline, EMBASE, and Cochrane databases during 2023. MeSH terms and keywords were inputted into each database. Abstracts and subsequently full texts were screened by 2 authors with conflicts resolved by a third author. A software called Covidence was used for data analysis and extraction. Papers focusing on the pediatric population were excluded. Various outcome measures included specialty of operator, number of prior scopes performed and patient satisfaction scores.

Results: In total, 1,246 studies were screened and 62 papers were included for analysis. The literature demonstrates there is no established competency-based framework for trainees to follow that would deem them experienced enough to carry out TNO independently. Indeed, senior colleagues who currently have an independent TNO practice themselves report varying experiences in their own training. There is no consensus on a prescriptive criteria in the literature that would deem one competent in this procedure, e.g. number of scopes undertaken. At present, exposure to TNO during training is limited to those working for consultants carrying out TNO regularly and not part of the curriculum in the UK.

Conclusions: This novel review forms part of a wider piece of work, led by our research group, aiming to develop TNO multidisciplinary consensus guidance for training and integrated service delivery in the UK. We have much to learn from our colleagues who undertake upper GI endoscopy who have significant experience in successfully developing a certification framework. Accreditation strengthens services, leads to increased patient confidence in a service, and allows for evaluation against standards which increase the quality of care provided. Further work is being undertaken with relevant stakeholders to develop this guidance which will have international reach.