Structured Pediatric Endoscopy Training: Lessons from Curriculum Innovation

Abstract

Background: Traditional pediatric endoscopy training often follows an informal apprentice-based model, leading to variability in skill acquisition—especially for therapeutic procedures. Simulation and competency-based frameworks have gained recognition but remain underutilized in many pediatric programs. A need existed for a formalized curriculum to standardize training and enhance technical proficiency. Objective: To evaluate the impact of a structured, multimodal endoscopy curriculum on fellows’ perceptions of training adequacy and procedural comfort. Methods: A structured endoscopy curriculum was implemented for six pediatric gastroenterology fellows over one academic year. The intervention included:

A restructured first-year introductory endoscopy month with didactics, simulation using the Thompson Endoscopic Skills Trainer®, consistent faculty educators, and an “endoscopy passport” to track progress. A second-year curriculum focused on advanced therapeutic techniques, including stricture dilation, polypectomy, endoscopic mucosal resection, deep enteroscopy, exposure to ERCP and third space endoscopy, and others. Quarterly simulation sessions for all fellows. On-demand educational endoscopy video tutorials and peer-reviewed journal opportunities. Pre- and post-intervention surveys assessed fellows’ perceived training adequacy and procedural comfort using a five-point Likert scale. Results: The curriculum significantly improved fellows’ perceptions of formal endoscopy training adequacy(mean score: 2.2 pre- vs. 4.2 post-intervention; p = 0.003). Perceptions of informal training remained unchanged (3.3 vs. 3.7; p > 0.05). Comfort with therapeutic endoscopy improved, though skill-specific gains did not reach statistical significance. Conclusions: A structured endoscopy curriculum enhances fellows’ confidence and perceived adequacy of training, particularly in formal endoscopy training. Simulation-based learning, a clear tracking system, and faculty standardization may contribute meaningfully to skill development. Future work should include objective competency assessments, larger cohorts, and integration of emerging technologies like virtual reality to further improve pediatric endoscopy training.