Delphi survey to explore core curriculum for training the next generation of hepatologists.

Key Takeaways for GI Nurses

• A large international panel of experts (456 in Round 1) reached strong consensus that interpretation of abnormal liver function tests and liver screening results, along with non-invasive fibrosis assessment, are core foundational competencies—skills that GI and endoscopy nurses are frequently the first to review, flag, or discuss with patients.
• As hepatology curricula formalize around non-invasive fibrosis assessment (e.g., FibroScan, serum biomarker panels) rather than relying solely on invasive procedures, nurses supporting hepatology clinics and endoscopy units should anticipate growing demand for competency in these diagnostic modalities.
• The consensus that management of major liver diseases is "essential" training content signals continued emphasis on multidisciplinary liver disease care—reinforcing the nurse's role in patient education, care coordination, and pre/post-procedural support for patients with chronic liver disease.
• This global framework may eventually shape institutional training standards and credentialing expectations, meaning nursing education and competency programs in GI/hepatology units may need to evolve in parallel to support physician trainees and maintain team-based care quality.

Clinical Relevance

Although this Delphi study is centered on physician trainee curriculum development, its findings have meaningful downstream implications for GI and endoscopy nursing practice. The strong consensus around foundational skills—interpreting liver function tests, liver screening results, and non-invasive fibrosis assessment—reflects the broader shift in hepatology away from invasive liver biopsy toward non-invasive diagnostic pathways. Nurses working in hepatology and endoscopy settings are often the point of first contact for patients undergoing these assessments, whether scheduling and prepping patients for elastography, drawing labs for fibrosis panels, or explaining results in the context of a treatment plan. As training standards solidify around these competencies, nurses can expect closer collaboration with hepatology fellows and attending physicians who are increasingly trained to prioritize these tools early in the diagnostic workup.

The emphasis on management of major liver diseases as essential curriculum content also underscores the continued complexity of patients seen in GI and endoscopy units—including those with cirrhosis, non-alcoholic fatty liver disease/metabolic dysfunction-associated steatotic liver disease (NAFLD/MASLD), viral hepatitis, and alcohol-associated liver disease. As disease etiologies shift globally, nursing teams will likely see changing patient population needs, requiring updated competencies in areas such as metabolic risk factor counseling, alcohol use screening, and management of complications like variceal bleeding or hepatic encephalopathy during endoscopic procedures.

From an operational standpoint, this study highlights the value of structured, consensus-driven curricula—a model that GI nursing education could similarly adopt. As hepatology training becomes more standardized internationally, nursing leadership may find opportunities to align in-house competency checklists, orientation programs, and continuing education offerings with the same core content areas physicians are being trained on, fostering more cohesive multidisciplinary care teams.

Bottom Line

While this study targets physician training, its core message—that non-invasive fibrosis assessment and liver function interpretation are now considered essential foundational skills in hepatology—signals a clear practice trend that GI and endoscopy nurses should track closely, as it will shape patient workflows, diagnostic testing volumes, and the multidisciplinary teamwork needed to deliver comprehensive liver disease care.