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Original research
Endoscopy training in the UK pre-COVID–19 environment: a multidisciplinary survey of endoscopy training and the experience of reciprocal feedback
  1. Elizabeth Ratcliffe1,
  2. Sharmila Subramaniam2,
  3. Wee Sing Ngu3,
  4. Susan McConnell4,
  5. Ian L P Beales5,
  6. Raymond McCrudden6,
  7. Geoff V Smith7,
  8. Christopher Wells8
  1. 1 Endoscopy department, Wrightington Wigan and Leigh NHS Foundation Trust, Leigh, UK
  2. 2 Gastroenterology, Queen Alexandra Hospital, Portsmouth, UK
  3. 3 JAG endoscopy representative, The Dukes' Club, London, UK
  4. 4 Endoscopy department, County Durham and Darlington NHS Foundation Trust, Darlington, Darlington, UK
  5. 5 Gastroenterology, Norfolk and Norwich University Hospital, Norwich, UK
  6. 6 Gastroenterology, Royal Bournemouth Hospital, Bournemouth, Bournemouth, UK
  7. 7 Health Education England South West, Bristol, UK
  8. 8 Gastroenterology, North Tees and Hartlepool NHS Foundation Trust, Hartlepool, Hartlepool, UK
  1. Correspondence to Dr Elizabeth Ratcliffe, Endoscopy department, Leigh Infirmary, Leigh, UK; elizabeth.ratcliffe{at}


Objective Training in gastrointestinal endoscopy in the UK occurs predominantly in a real world one-to-one trainer to trainee interaction. Previous surveys have shown surgical and gastroenterology trainees have had mixed experiences of supervision and training, and no surveys have explored specifically the role of trainee to trainer feedback. This study aimed to explore the experience of training and of providing trainer feedback for all disciplines of endoscopy trainees.

Design/method An online survey designed in collaboration with Joint Advisory Committee training committee and trainee representatives was distributed from January 2020 but was interrupted by the COVID-19 pandemic and hence terminated early.

Results There were 129 responses, including trainees from all disciplines and regions, of which 86/129 (66.7%) rated the culture in their endoscopy units favourably—either good or excellent. 65/129 (50.4%) trainees reported having one or more training lists allocated per week, with 41/129 (31.8%) reporting only ad hoc lists. 100/129 (77.5%) respondents were given feedback and 97/129 (75.2%) were provided with learning points from the list. 65/129 (50.4%) respondents reported their trainer completed a direct observation of procedure or direct observation of polypectomies. 73/129 (56.6%) respondents reported that they felt able to give feedback to their trainer, with 88/129 (68.2%) feeling they could do this accurately. Barriers to trainer feedback cited included time constraints, lack of anonymity and concerns about affecting the trainer–trainee relationship.

Conclusion Overall, the training environment has improved since previous surveys. There are still issues around interdisciplinary differences with some surgical trainees finding the training environment less welcoming, and trainee perceptions of hierarchical barriers and trainer responsiveness to feedback limiting the accuracy of their feedback.

  • endoscopy
  • colorectal surgery
  • diagnostic and therapeutic endoscopy
  • endoscopic procedures
  • surgical training

Data availability statement

Data are available on reasonable request.

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  • Contributors ER devised the initial survey with CW and WSN, all authors reviewed draft survey and contributed to the final survey design. Data were analysed by ER, CW, WSN, SS and all authors were given opportunity to comment and advise on the data. ER produced the initial draft manuscript which was reviewed and edited by SS, WSN and CW. All authors then reviewed and contributed to the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.