PWE-113 Haemostasis experience on completion of specialist training in gastroenterology: analysis of the jets e-portfolio

Introduction Upper gastrointestinal bleeding (UGIB) is a common life-threatening emergency. Gastroenterologists are typically expected to be competent in delivering endotherapy for UGIB, with the Certificate of Completion of Training (CCT) often heralding the onset of participation in on-call UGIB rotas. We aimed to analyse the volume of haemostasis experience recorded by gastroenterology CCT holders on the JAG Endoscopy Training System (JETS) e-Portfolio. Methods In this retrospective UK-wide study, gastroenterologists awarded CCT between April 2014-April 2017 were identified from the specialist register. Credentials were cross-referenced with JETS to retrieve UGIB endotherapy experience prior to CCT. Subjects without e-portfolio involvement or those not identified on cross-referencing were excluded. Sensitivity analyses were undertaken using the lifetime gastroscopy count to evaluate validity of JETS data. Haemostasis experience was measured only for JETS-supported modalities and collated according to variceal and non-variceal therapies. The outcome measured was the number of recorded procedures requiring haemostasis, e.g. a procedure in which 3 clips were applied was considered as 1 procedure. Comparisons of continuous variables were made using Mann-Whitney (2 groups) and Kruskal-Wallis tests (>2 groups). Results Over the 3-year study period, 241 gastroenterologists were awarded CCT. After exclusions (N=9), 232 were included for analysis. Sensitivity analysis revealed a median lifetime gastroscopy count of 854 (IQR 60–214), without variation over the three years (P=0.817), attesting to data integrity. A total of 12,932 endotherapy procedures for UGIB were recorded, corresponding to a median of 42 (IQR 2–1) per gastroenterologist. Exposure to non-variceal modalities (median 28, IQR 1–2) was more frequent than variceal therapies (median 11, IQR –2; P Conclusion Based on JETS data, exposure to UGIB endotherapy prior to CCT appears to vary between gastroenterologists, by training deanery and by procedural modality. Implementation of standardised UGIB hands-on training courses and certification may help to support and quality assure training in endotherapy.