Formative & Summative Assessment in Endoscopy

Direct Observation of Procedural Skills - DOPS

Guidance Notes

Background

This assessment method is now widely used, accepted, and in general validated, in the UK and elsewhere. This current suite of DOPS form builds on work carried out previously by the JAG, the Royal College of Physicians of London, the network of endoscopy training centres, and the NHS Bowel Cancer Screening Programme. The appropriate DOPS forms can be used formatively throughout training and as an independent endoscopist, to guide development of skills and practice.

There are currently five main DOPS forms, each with a formative and a summative version:

Each main form comes with a detailed set of descriptors of levels of skill expected at each of the four possible grades for a skill domain. Formative versions have a “Learning objectives for next case” comments box at the foot of each form. The summative versions, used for accreditation in endoscopy, have a second page with a box for “Expert Global Evaluation” and a sign-off from the assessors.

The range of uses is therefore to:

formatively assess endoscopists in training to aid development
summatively assess endoscopists in training for accreditation for independent endoscopy
assess screening colonoscopists for accreditation for bowel cancer screening
help maintain and develop skills in independent endoscopists following their initial successful accreditation

However, the DOPS is only part of a multi-method assessment strategy in all of these situations, and supplements the performance data of a practitioner. For trainees therefore, for each of the main procedures, there are also:

Eligibility criteria for provisional accreditation, along with ….
Guidelines on further development leading to full accreditation. (links to five sets of criteria)

Use of the DOPS form

For all uses, please familiarise yourselves with the domains in the DOPS, the grades of achievement, and the grade descriptors. These descriptors are given in detail for each of the main procedures here.

Grading standards using the DOPS

The standards as outlined are set at the high level necessary for independent, (safe & competent) endoscopy. When used formatively, trainers should therefore be awarding grades 1 and 2 routinely to trainees, and trainees should expect this. Grade 3 is a high level of competence, and grade 4 implies mastery of the skill, which may never be attained by many.