Related Experiment Video
Updated: May 10, 2026

Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists
Published on: July 11, 2025
Interim report of a randomized cross-over study comparing clinical performance of novice trainee endoscopists using
Catherine Ngo1, Joseph W Leung, Surinder K Mann
1University of California Davis, USA.
Background:
The applicability of water method colonoscopy in trainee education is not known.
Aim:
To compare the water method vs. usual air method in teaching novice trainee colonoscopy.
Method:
An IRB approved prospective randomized cross-over study (NCT01482546) in a university setting with diverse patient population.
Design:
Three first year GI fellows consented to participate in the study. Trainees were randomized to learn with either usual air method or the water method in performing colonoscopy with a dedicated endoscopy attending during their weekly outpatient endoscopy clinics for the initial six months of training and then cross-over to the other method for the remaining six months.
Patients:
Patients undergoing screening, surveillance or diagnostic colonoscopy.
Results:
The interim data revealed no significant difference in age, gender, and body mass index (BMI). Trainees rated the water method colonoscopy as significantly easier to learn compared to the air method (p=0.007).
Conclusions:
The interim data demonstrate positive effects of using the water method in training novice endoscopists who reported a significant ease of learning colonoscopy using this method. Training programs could consider joining us in evaluating the use of warm water infusion in colonoscopy education.
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