{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T10:36:58Z","timestamp":1792838218210,"version":"4.5.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":137,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Objective assessment of surgical technical skills is essential for ensuring patient safety and maintaining high\u2010quality surgical care. Although the Endoscopic Surgical Skill Qualification (ESSQ) System of the Japan Society for Endoscopic Surgery (JSES) has contributed to the standardization of endoscopic surgery, factors associated with pass\u2013fail outcomes in the certification examination have not been systematically evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational study included applicants who underwent the colorectal endoscopic surgical skill qualification examination between 2020 and 2024. Applicant\u2010, institutional\u2010, patient\u2010, tumor\u2010, surgical\u2010, and reviewer\u2010related variables registered at the time of application were analyzed. Associations with pass\u2013fail outcomes were assessed using uni\u2010 and multivariable analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1945 applications were analyzed. The overall pass rate during the study period was 33.2%, with robot\u2010assisted cases showing comparable results, although the number of robot\u2010assisted cases was limited. Primary reviewers agreed in 68.1% of cases, and the overall Cohen's kappa was 0.336. Multivariable analysis identified fewer application attempts, larger institutional bed capacity, 3D scope use, shorter operative time, and lower blood loss as independent predictors of successful qualification (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Reviewer demographics showed no associations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provided the first comprehensive evaluation of factors associated with pass\u2013fail outcomes in the ESSQ Examination of the JSES. Certification results were influenced by applicant\u2010 and institution\u2010related characteristics, as well as operative performance indicators, whereas reviewer demographic factors showed no measurable impact.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70300","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T07:20:59Z","timestamp":1779088859000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors Associated With Pass\u2013Fail Outcomes in the Colorectal Endoscopic Surgical Skill Qualification Examination: A Retrospective Observational Study Using Data From 2020 to 2024"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8641-8197","authenticated-orcid":false,"given":"Suguru","family":"Hasegawa","sequence":"first","affiliation":[{"name":"Colorectal Section, Technical Review Committee, Japan Society for Endoscopic Surgery (JSES), Department of Surgery Fukuoka University Hospital  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroya","family":"Kuroyanagi","sequence":"additional","affiliation":[{"name":"Technical Review Committee, JSES, Department of Gastrointestinal Surgery Toranomon Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichiro","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Colorectal Section, Technical Review Committee, JSES, Department of Surgery Kindai University Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Kinugasa","sequence":"additional","affiliation":[{"name":"Certification System Committee, JSES, Department of Gastrointestinal Surgery Institute of Science Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutaka","family":"Obama","sequence":"additional","affiliation":[{"name":"Surgical Data Science Committee, JSES, Department of Gastrointestinal Surgery Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Kitagawa","sequence":"additional","affiliation":[{"name":"President, JSES, Department of Surgery Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"issue":"2","key":"e_1_2_10_2_1","first-page":"273","article-title":"Objective Structured Assessment of Technical Skill (OSATS) for Surgical Residents","volume":"84","author":"Martin J. 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