What is it about?
In this study, we asked the following questions: 1)How well is colonoscopy performed during the training period and in the newly independent practice? 2)What factors predict good newly independent practice, as measured by the colonoscopy procedure completion rate?
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Why is it important?
To our knowledge, this is the first study that looks at colonoscopy performance in the newly independent setting. Our data showed: 1) Trainees improve in a near linear fashion in terms of procedure completion, polyp detection (less missed lesions), lower discomfort scores for patients, and lower sedation doses. 2) On average, newly independent trainees met international completion rate standards (completing at least 90% of colonoscopy procedures without assistance) 3) There are a small proportion of trainees who have a drop in performance (DIP). These trainees have borderline completion rates and lower number of lifetime colonoscopy experience compared to those who did not. The trainer specialty was also a significant predictor of DIP. There were no differences in DIP according to the trainee specialty, i.e. whether the trainee was a surgeon, gastroenterologist or nurse endoscopist.
Perspectives
This study also highlights the merits of having a national certification/credentialing system to identify when trainees are ready to perform colonoscopy independently, and also, the need for monitoring performance during this newly-independent period. This is required to safeguard patient outcomes, and provide additional support to the endoscopist as needed.
Dr Keith Siau
Joint Advisory Group on Gastrointestinal Endoscopy
Read the Original
This page is a summary of: Performance indicators in colonoscopy after certification for independent practice: outcomes and predictors of competence, Gastrointestinal Endoscopy, August 2018, Elsevier,
DOI: 10.1016/j.gie.2018.07.032.
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