Physiological Sciences

Profile of a gastrointestinal physiologist

Area of Investigation
Gastro-intestinal physiologists provide a physiological assessment service in Gastroenterology. Investigative techniques of an invasive nature are used to investigate disease processes throughout the gastrointestinal (GI) tract. The role of the GI physiologist is to be responsible for performing all aspects of the required procedures and contributing to the overall clinical management of the patients. The majority of the investigations involve invasive procedures that are classed as minor surgical procedures. An established GI Physiology Unit will be headed by an experienced GI physiologist who will provide expert advice on selection and reporting of the investigations for optimum diagnostic outcome.

The investigations are undertaken for the diagnosis of myopathic, neuropathic or functional disorders of the GI tract. This encompasses the following:

1. Motor dysfunction of the GI tract.
2. Sensory dysfunction of the GI tract.
3. Duodeno-gastro oesophageal reflux disease.
4. Detection of microbial disorders.
5. Pelvic floor dysfunction.
Therapeutic techniques are undertaken in pelvic floor disorders.
The competent practitioner will provide a range of services which will include:-
1. The planning and performance of a wide range of investigations for the diagnosis and assessment of GI disease.
2. Analysis and technical reporting of the data measurements from the diagnostic or therapeutic procedures undertaken.
3. Advice and professional opinion on the appropriateness of investigations.
4. Direct management of implanted devices.
5. Contribute to the overall clinical management of the patient
6. The provision of a safe working/clinical environment.
7. Evaluation, procurement, calibration and quality control procedures for all equipment used within the GI physiology environment.
8. Maintenance of records for all procedures for audit purposes.
9. Teaching, training and continuing medical education of GI physiologists.
10. Specialist education of other health care professionals.
11. Involvement in research and development in the field of gastroenterology.

Education & Training requirements
To achieve Accredited Independent Practitioner status the applicant must have a BSc (Hons) Clinical Physiology or an appropriate science or nursing qualification; Association of Gastrointestinal Physiologists (AGIP) professional exams and evidence and assessment of clinical and professional competencies achieved.

Training units have been accredited around the country, ensuring national standardisation of practice

To support the AGIP educational programme AGIP has published;

• The Study Guide in Gastroenterology – a self study guide to accompany the year one specialist option
• Assessment tools for the continuous assessment of trainee GI Physiologists

The Association of Gastrointestinal Physiologists

Background
The proposal to allow an associate group of healthcare practitioners, undertaking GI physiological measurement was accepted by the British Society of Gastroenterology in1991, with changes to BSG constitution and ratification in 1992. The move towards standardisation of tests began at a meeting of GI practitioners in June 1992, with key individuals attending; Dr Peter Woodford (Chief Scientific Officer, DoH), Mr Terry Jones (Coventry University) and Dr John Simpkins (Peoples College). [Lennard-Jones J, The History of Physiological Measurement in Gastroenterology New Wave 2002]

The standardisation of investigations and the move towards formal professional body examinations was the cornerstone of the ethos of AGIP. This has continued and developed to present day, particularly in context with national occupational standards and the registration of GI physiologists under the umbrella of RCCP and the Institute of Physiological Sciences.

In the thirteen years since AGIP’s inception, an ONC, HND and BSc (Hons) in GI Physiology have been developed in line with other clinical physiology disciplines. Post Graduate and MSc courses are also under discussion.

An accreditation scheme, quarterly Journal, web site, symposium (within the main BSG meeting) and peer reviewed papers which are published in GUT are all developments which reinforce the professionalism and dedication of all AGIP members.

The role of AGIP is to:

• Promote the safe and competent working practice, the assurance of high quality services and the cutting edge development of research in gastro-intestinal pathology
• Ensure the provision and the regular evaluation of education & training programmes for GI practitioners
• Share of good practice and research methods amongst all health care professionals
• Communicate new developments in the NHS, peer reviewed publications and British Society of Gastroenterology Guidelines via “New Wave”
• Improve the profile of both GI practitioners and healthcare science
• Highlight the problem of incompetence to practice of other healthcare professionals performing GI function tests who have little understanding of interpretation of these tests
• Be involved with healthcare scientist's in the modernisation agenda and policy development

Membership
Accredited Independent Practitioner status is usually awarded to AGIP members who have completed a recognised academic course and have a minimum of 4 years experience in clinical practice.

Affiliated Practitioner status is awarded to those AGIP members who either have a limited academic and clinical role or to those who have a purely academic role in GI Physiology. The membership also includes Fellows and Honorary Fellows.

It is a multidisciplinary professional group attracting equal numbers of staff from clinical physiology, clinical science , upper & lower GI nurse specialists
and medical staff working in the field.

Continuing Professional Development
All accredited AGIP members take seriously the responsibility to continually update their knowledge and expertise in the field of gastroenterology. A CPD template is available on the AGIP website (www.giphysiology.org) and is linked to re-registration.

As an associate group of the British Society of Gastroenterology the annual BSG conference includes a peer reviewed paper and poster session. AGIP also has a joint symposium with other Healthcare Science Groups e.g. bi-annual meetings with IPEM, annual meetings with the Society of Coloproctologists.

Professional partnerships
The Association works in conjunction with the British Society of Gastroenterology, The Society of Coloproctology and The Royal College of Physicians to produce national guidelines and standards for good practice in upper and lower GI investigations.

The AGIP Education and Accreditation Group works closely with education providers to establish course content and recommend specialist lecturers for the Specialist Options on the BSc Clinical Physiology. The AGIP maintains links with other professional bodies in Clinical Physiology via the Registration Council for Clinical Physiology (RCCP), the Institute for Physiological Sciences (IPS) and the Federation for Healthcare Science (FHCS).

Other connections exist with Scottish and Irish practitioners via the BSG.