The gastrointestinal endoscopy competency assessment tool for pediatric colonoscopy

UMMS Affiliation

Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition

Publication Date


Document Type



Gastroenterology | Pediatrics


OBJECTIVES: Validated assessment tools are required to support competency-based education. We aimed to assess the reliability and validity of the Gastrointestinal Endoscopy Competency Assessment Tool for Pediatric Colonoscopy (GiECATKIDS), an instrument developed by 41 North American experts using Delphi methodology.

METHODS: GiECATKIDS consists of a 7-item global rating scale (GRS) and an 18-item checklist (CL). An attending physician assessed 104 colonoscopies performed at 3 North American hospitals by 56 endoscopists, including 25 novices (procedures), 21 intermediates (50-250), and 10 advanced endoscopists ( > 500). Another observer rated procedures to assess interrater reliability using intraclass correlation coefficient (ICC). Test-retest reliability was measured with ICC comparing endoscopists' first and second procedure scores. Discriminative validity was examined by comparing experience level with scores. Concurrent validity was assessed by correlating scores with colonoscopy experience, cecal and terminal ileal intubation rates, and physician global assessment.

RESULTS: Interrater reliability of the GiECATKIDS was high (total: ICC = 0.88; GRS: ICC = 0.79; CL: ICC = 0.89). Test-retest reliability was excellent (total: ICC = 0.94; GRS: ICC = 0.94; CL: ICC = 0.84). GiECATKIDS total, GRS, and CL scores differed significantly among novice, intermediate, and advanced endoscopists (P < 0.001). There was a significant positive correlation (P < 0.001) between scores and number of previous colonoscopies (total: rho = 0.91, GRS: rho = 0.92, CL: rho = 0.84), cecal intubation rate (total: rho = 0.82, GRS: rho = 0.85, CL: rho = 0.77), ileal intubation rate (total: rho = 0.82, GRS: rho = 0.82, CL: rho = 0.80), and physician global assessment (total: rho = 0.95, GRS: rho = 0.94, CL: rho = 0.89).

CONCLUSIONS: The GiECATKIDS demonstrates strong reliability and validity as a measure of performance of pediatric colonoscopy that can be used to support training and assessment.

DOI of Published Version



J Pediatr Gastroenterol Nutr. 2015 Apr;60(4):474-80. doi: 10.1097/MPG.0000000000000686. Link to article on publisher's site

Journal/Book/Conference Title

Journal of pediatric gastroenterology and nutrition

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Link to Article in PubMed

PubMed ID