We want all candidates to do well during their assessment. This table shows the pass/fail percentages for each individual item on DOPS forms from 2018 to end of May 2020.
Candidates most frequently failed on areas relating to tip control, proactive problem solving, loop management, pace and progress, and visualisation. Below describes what the assessors will be looking for in each of these areas.
- Integrated technique: Combines tip and torque steering to accurately control the tip of colonoscope and manoeuvre the tip in the correct direction.
- Individual components.
- Tip steering: Avoids unnecessary mucosal contact and maintains luminal view, avoiding need for blind negotiation of flexures and 'slide-by' where possible
- Torque steering: Demonstrates controlled torque steering using right hand/fingers to rotate shaft of colonoscope
- Luminal awareness: Correctly identifies luminal direction using all available visual clues, and avoids red outs
Proactive problem solving
- Anticipates challenges and problems (e.g. flexures and loops)
- Uses appropriate techniques and strategies to prevent problems and minimise difficulties and patient discomfort
- Recognition: Early recognition of technical challenges and difficulties preventing progression (e.g. loops, fixed pelvis)
- Management: Can articulate and demonstrate a logical approach to resolving technical challenges, including early change in strategy when progress not being made
- Uses appropriate techniques (tip and torque steering, withdrawal, position change) to minimise and prevent loop formation
- Early recognition of when loop is forming or has formed
- Understands and can articulate techniques for resolution of loops
- Resolves loops as soon as technically possible, to minimise patient discomfort and any compromise to scope function
- Recognises when loop resolution not possible and safely inserts colonoscope with loop, with awareness and management of any associated patient discomfort
Pace and progress
Takes sufficient time to maximise mucosal views
- Insertion of colonoscope speed adjusted to minimise looping, prevent problems and manage difficulties
- Able to complete both insertion and withdrawal at pace consistent with normal service lists, adjusted, depending on difficulty of procedure
Extent of examination is appropriate to the indication
- Visually and digitally examines the rectum and perineum (or stomal) area to ensure no obstruction or contraindication to insertion of instrument
- Well-judged and timely use of screen washes and water irrigation to ensure clear views
- Utilises positional changes to maximise mucosal views
- Ensures optimal luminal views throughout the examination
- Uses mucosal washing and suction of fluid to ensure optimal visualisation of mucosa, particularly at potential blind spots (caecal pole, flexures, recto-sigmoid).
- Retroversion in the rectum should be performed to fully visualise the lower rectum and dentate line. If rectal retroversion is not possible, the reason should be indicated.
- Recognises and identifies landmarks of complete examination (appendix orifice, ileo- caecal valve, tri-radiate fold or anastomosis/neo-terminal ileum)
There is photo-documentation (or video) of significant findings and landmarks of completion.
Please review the full DOPS assessment form to help guide you as to what the assessors will be looking for in each of these areas. This will help you prepare for your assessment and give you the best chance of successfully gaining accreditation. If you undertake polypectomy during your assessment, then your polypectomy skills will be assessed using the DOPyS assessment form.