Only six states require endoscopy technicians to complete sterile processing technician certification training. Experts say the disconnect between states has created a need for clinics and programs to incentivize technicians to receive formal training.

Connecticut, Delaware, New Jersey, New York, Pennsylvania and Tennessee have laws that require certification. Three more states—Florida, Massachusetts and Minnesota—are considering enacting similar laws. But the vast majority of states leave training up to endoscopy clinics.

“Depending on the local policy, a technician may train for four to six weeks on the job before they are on their own,” said Gottumukkala Subba Raju, MD, the John Stroehlein Distinguished Professor of Medicine at The University of Texas MD Anderson Cancer Center, in Houston.

Cynthia M. Friis, MEd, BSN, RN, NPD-BC, an associate executive director of clinical affairs at the Society of Gastroenterology Nurses and Associates (SGNA), agreed that the expectations of endoscopy technicians vary greatly between clinics, and not just formal certification requirements. “Sometimes they are a scope reprocessor. Sometimes they play a more active role during the procedure,” she said. “It really depends on the facility.”

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At baseline, managers in charge of training should teach all new endoscopy technicians to follow the manufacturers’ instructions for use, said Garland Grisby, CFER, CSPDT, an endoscope service manager at Kaiser Permanente, in San Francisco, and the co-chair of the Association for the Advancement of Medical Instrumentation’s Working Group 84, which focuses on endoscope reprocessing.

“We always want to go off of manufacturers’ instructions. However, some facilities might have a mixed fleet, and some of those instructions for use are different,” he said, noting that this can cause discrepancies in how endoscopes are being processed.

Moving Toward Standardized Training

“There has always been a push for more nationwide standards,” Mr. Grisby said. Pointing out that people in fields such as cosmetology need to be certified, he said, “If those trades require certifications, why shouldn’t we?”

Ms. Friis said she has noticed a concerted effort to standardize reprocessing technician training in recent years.

To that end, several industry groups have created training programs for endoscopy and sterile processing technicians. The Certification Board for Sterile Processing and Distribution and Healthcare Sterile Processing Association tests can be taken by anyone in the country. In addition, SGNA has two continuing education gastroenterology technician specialist programs that are tailored based on experience.

Ms. Friis said the focus of both SGNA programs is on allowing students to ask questions throughout the courses and providing them with context about the purpose of each stage. “It gives a reason for why someone is doing a step and helps the information stick more,” she said.

Incentivizing Formal Training

Dr. Raju has taken another approach to increase technician education. He partnered with the American Society for Gastrointestinal Endoscopy (ASGE) and Houston Community College to design a new kind of endoscopy technician training course that is flexible and easily tailored to people who are new to the field and those with prior work experience (GEN Priority Report 2022 July;20-21,34).

One of the goals of developing the training programs was to create a pipeline of qualified technicians who are ready to work. Another was to ensure people who took on extra schooling, outside of on-the-job-training, had an incentive to do so. This includes opportunities to expand their careers.

A person without prior experience can take 35 credit hours through Houston Community College. Students at Houston Community College also will complete two semesters of part-time on-the-job training.

Alternatively, an experienced technician working in an endoscopy unit can access 19 credit hours of endoscopy course subjects online through ASGE.


Students in the community college program also will have the chance to take a final exam designed by Dr. Raju and ASGE to ensure competency before graduating. If a technician already has work experience, they can opt to “test out” of the program. If they pass the test, they will receive 19 credit hours from the college without needing to take those classes. If they want to go for Level II training, they can complete another 16 credit hours, which can be applied toward a Level II certificate at Houston Community College where they later can go for an associate degree.

A Model to Replicate

Dr. Raju acknowledged that each clinic runs a bit differently, but a standardized training program like this will better prepare new technicians to enter the workforce with a good understanding of how to complete tasks, as well as the knowledge needed to ask questions to clarify each clinic’s process. There would be baseline knowledge so that training for a new technician doesn’t need to start from scratch.

Another important aspect central to the training was designing it in a way that can be replicated by other community colleges across the country, creating a new normal where people are incentivized to complete formal endoscopy technician training.

“Ultimately the goal is to freely share that information,” Dr. Raju said. “If a community college in Chicago or Denver wants to start this program, they can use the material and have somebody locally teach it.”

—Kaitlin Sullivan

The sources reported no relevant financial disclosures.

This article is from the July 2024 Priority Report print issue.