Mapping Competence in Gastrointestinal Endoscopy Nursing Practice: An Item Response Theory Analysis of Perceived Skill Acquisition and Maintenance in Italy

Bozzetti, Mattia; Pascale, Gennaro; Marcomini, Ilaria; Lo Cascio, Alessio; Grilli, Fabio; Sclapari, Caterina; Multari, Grazia; Orgiana, Nicoletta; Gaggiotti, Mirko; Iori, Giorgio; Giordano, Luciana Nicola; Mancin, Stefano; Petrelli, Fabio; Cangelosi, Giovanni; Lopetuso, Loris Riccardo; Napolitano, Daniele

doi:10.3390/healthcare14020203

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Open AccessArticle

Mapping Competence in Gastrointestinal Endoscopy Nursing Practice: An Item Response Theory Analysis of Perceived Skill Acquisition and Maintenance in Italy

by

Mattia Bozzetti

^1,†

,

Gennaro Pascale

^2,†

,

Ilaria Marcomini

³

,

Alessio Lo Cascio

⁴

,

Fabio Grilli

⁵,

Caterina Sclapari

⁶,

Grazia Multari

⁷,

Nicoletta Orgiana

⁸,

Mirko Gaggiotti

⁹,

Giorgio Iori

¹⁰,

Luciana Nicola Giordano

¹¹,

Stefano Mancin

¹²

,

Fabio Petrelli

^13,*,

Giovanni Cangelosi

^13,*

,

Loris Riccardo Lopetuso

^11,14,‡ and

Daniele Napolitano

^11,‡

¹

Direction of Health Professions, ASST Cremona, 26100 Cremona, Italy

²

AORN Sant’Anna e San Sebastiano, 26100 Caserta, Italy

³

Center for Nursing Research and Innovation, Faculty of Medicine and Surgery, Vita–Salute San Raffaele University, 20132 Milan, Italy

⁴

Direction of Health Professions, La Maddalena Cancer Center, 90146 Palermo, Italy

⁵

Endoscopia Digestiva Chirurgica–Fondazione Policlinico Gemelli IRCCS, 00168 Rome, Italy

⁶

UOC Gastroenterologia ed Endoscopia Digestiva, G.O.M Bianchi Melacrino Morelli, 89124 Reggio Calabria, Italy

⁷

SOD di Chirurgia Endoscopica, Dipartimento Assistenziale di Area Medica-Presidio ‘Pugliese’, Azienda Ospedaliera Universitaria ‘Renato Dulbecco’ di Catanzaro, 88100 Catanzaro, Italy

⁸

CUT, Fondazione Policlinico Gemelli IRCCS, 00168 Rome, Italy

⁹

Clinica di Gastroenterologia ed Epatologia, Ospedale Santa Maria Della Misericordia, Azienda Ospedaliera di Perugia, 06129 Perugia, Italy

¹⁰

Gastroenterologia ed Endoscopia Digestiva di Reggio Emilia, Azienda USL di Reggio Emilia IRCCS Ospedale S. Maria Nuova, 42123 Reggio Emilia, Italy

¹¹

CEMAD, Fondazione Policlinico Gemelli IRCCS, 00168 Rome, Italy

¹²

IRCCS Humanitas Research Hospital, 20089 Milan, Italy

¹³

School of Pharmacy, Experimental Medicine and “Stefani Scuri” Public Health Department, University of Camerino, 62032 Macerata, Italy

¹⁴

Department of Life Science, Health, and Health Professions, Link Campus University, 00165 Rome, Italy

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^*

Authors to whom correspondence should be addressed.

^†

These authors contributed equally to this work as the First Author of this Work.

^‡

These authors contributed equally to this work as the Last Author of this Work.

Healthcare 2026, 14(2), 203; https://doi.org/10.3390/healthcare14020203

Submission received: 13 November 2025 / Revised: 5 January 2026 / Accepted: 12 January 2026 / Published: 13 January 2026

(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)

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Abstract

Objective. The aim of this study was to define a structured competence model for nurses working in gastrointestinal endoscopy in Italy and to assess nurses’ perceptions of the number of procedural repetitions required to acquire and maintain competence across different endoscopic procedures. Methods. A cross-sectional online survey targeted registered nurses working in Italian gastrointestinal endoscopy units. The questionnaire, developed from guidelines and expert consensus, covered demographics, organizational context, and perceived repetition thresholds for 30 procedures. Partial Credit Models (PCMs) estimated acquisition and maintenance thresholds; Differential Item Functioning (DIF) tested differences by self-reported experience level. Results. A total of 332 nurses participated (68.4% female; mean age 47.1 years; mean endoscopy experience 10.1 years). For competence acquisition, most procedures were placed in the 11–30 or 31–50 repetition range, with higher values for complex techniques. Competence maintenance generally required fewer repetitions, but thresholds varied by procedure. Advanced or infrequently performed techniques were perceived as more demanding. More experienced nurses reported higher thresholds, reflecting stricter internal standards. Conclusions. Acquisition and maintenance of gastrointestinal endoscopy competences differ in intensity and frequency requirements, supporting the need for tailored, modular training pathways. Findings highlight the importance of national competence standards, adaptive learning technologies, and structured mentorship to enhance skill development, reduce variability, and promote consistent, high-quality patient care across Italy.

Keywords: nursing; competence; clinical and assistive skill; cross-sectional survey; Italy

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MDPI and ACS Style

Bozzetti, M.; Pascale, G.; Marcomini, I.; Lo Cascio, A.; Grilli, F.; Sclapari, C.; Multari, G.; Orgiana, N.; Gaggiotti, M.; Iori, G.; et al. Mapping Competence in Gastrointestinal Endoscopy Nursing Practice: An Item Response Theory Analysis of Perceived Skill Acquisition and Maintenance in Italy. Healthcare 2026, 14, 203. https://doi.org/10.3390/healthcare14020203

AMA Style

Bozzetti M, Pascale G, Marcomini I, Lo Cascio A, Grilli F, Sclapari C, Multari G, Orgiana N, Gaggiotti M, Iori G, et al. Mapping Competence in Gastrointestinal Endoscopy Nursing Practice: An Item Response Theory Analysis of Perceived Skill Acquisition and Maintenance in Italy. Healthcare. 2026; 14(2):203. https://doi.org/10.3390/healthcare14020203

Chicago/Turabian Style

Bozzetti, Mattia, Gennaro Pascale, Ilaria Marcomini, Alessio Lo Cascio, Fabio Grilli, Caterina Sclapari, Grazia Multari, Nicoletta Orgiana, Mirko Gaggiotti, Giorgio Iori, and et al. 2026. "Mapping Competence in Gastrointestinal Endoscopy Nursing Practice: An Item Response Theory Analysis of Perceived Skill Acquisition and Maintenance in Italy" Healthcare 14, no. 2: 203. https://doi.org/10.3390/healthcare14020203

APA Style

Bozzetti, M., Pascale, G., Marcomini, I., Lo Cascio, A., Grilli, F., Sclapari, C., Multari, G., Orgiana, N., Gaggiotti, M., Iori, G., Giordano, L. N., Mancin, S., Petrelli, F., Cangelosi, G., Lopetuso, L. R., & Napolitano, D. (2026). Mapping Competence in Gastrointestinal Endoscopy Nursing Practice: An Item Response Theory Analysis of Perceived Skill Acquisition and Maintenance in Italy. Healthcare, 14(2), 203. https://doi.org/10.3390/healthcare14020203

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Mapping Competence in Gastrointestinal Endoscopy Nursing Practice: An Item Response Theory Analysis of Perceived Skill Acquisition and Maintenance in Italy

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