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Updated: Jul 13, 2026
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E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Talking to patients about screening colonoscopy--where conversations fall short
Robin E Canada1, Barbara Turner
1Internal Medicine Residency Program of the Hospital of the University of Pennsylvania, Primary Care Program; Medical Staff, Whiteriver Indian Health Service, Whiteriver, AZ, USA.
The Journal of Family Practice
|August 3, 2007
Summary
Physicians often omit crucial details when recommending colonoscopy for colorectal cancer screening. Enhancing patient preparation with supplementary information is vital for effective screening.
Area of Science:
- Medical communication
- Preventive medicine
- Gastroenterology
Background:
- Physician recommendations significantly influence patient adherence to colorectal cancer screening via colonoscopy.
- Current understanding of physician communication strategies regarding colonoscopy is limited.
Purpose of the Study:
- To analyze how primary care physicians and physicians-in-training discuss screening colonoscopies with patients.
- To identify key informational components, message framing, numeracy, and language used in these consultations.
Main Methods:
- 30 physicians from 4 practices participated in simulated patient counseling sessions for screening colonoscopy.
- Encounters were audio-recorded, transcribed, and analyzed for specific communication elements.
- Assessment included informational points, message framing (positive/negative), numeracy, and language style.
Main Results:
- Most physicians (>=80%) covered colonoscopy benefits, procedural status, and sedation.
- Few physicians (<20%) discussed risks, scheduling, or necessary preparation (diet/medication changes).
- Overwhelmingly positive framing (98%) was used, with 67% also emphasizing risks of non-screening; numeracy and language varied.
Conclusions:
- While physicians generally use positive and simple language for colonoscopy recommendations, critical information is frequently omitted.
- Addressing these informational gaps through enhanced patient education is necessary for adequate preparation.
- Improved communication strategies are needed to ensure patients are fully informed about screening colonoscopy.
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