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The terminology used in this chapter is meant to facilitate the reader’s deconstruction of endoscopic skill sets and hence the specific terms are less important than the underlying principles they are meant to illustrate. It is hoped that individual trainers will consider the various advantages afforded by deconstructing skill sets in such a manner when designing or adapting their own training programs. Subsequent chapters will cover training in the major endoscopic procedures and in specific techniques using a variety of different perspectives. The reader is encouraged to approach these chapters with their own framework in mind.

In this section, we will discuss the following skills, which we consider to be constant requisites in the technical performance of any form of gastrointestinal endoscopy. It is assumed that prior to introducing a trainee to the technical components of performing endoscopy, they have already become familiar with the various components of the endoscope, including the function of the air/water and suction buttons, as well as proper holding and handling of the endoscope and other practical aspects such as troubleshooting malfunctioning equipment. Ideally, these basic skills have been introduced to the trainee and practiced in an environment away from the patient until a minimum level of proficiency has been reached.

1 Introduction of the endoscope: Comfortable and safe introduction of the scope into the GI tract through an orifice (oropharynx, anus, stoma).

2 Navigation: Navigation of a flexible instrument through a tubular conduit until a goal or end point is reached.

3 Overcome obstacles: Strategies to navigate across sphincters, around sharp curves, and through areas of resistance.

4 Inspection: Careful and thorough inspection of the mucosal surface.

5 Instrumentation: Advancing an instrument through an accessory channel to a specific point, while maintaining a stable view of the target and then subsequently performing the desired task.

These skills will be discussed in some detail, including the nuances that affect their learning.