The Goalposts Have Moved: Can Surgery Residents Meet Updated Quality Benchmarks for Adenoma Detection Rate in...

Area of Science:

• Gastroenterology
• Surgical Education

Background:

• The American Society for Gastrointestinal Endoscopy (ASGE) and American College of Gastroenterology Task Force (ACGTF) updated colonoscopy quality benchmarks in 2015.
• Previous studies indicated surgery residents could perform competent screening colonoscopies within a structured curriculum.

Purpose of the Study:

• To evaluate if surgery residents could achieve the updated adenoma detection rate (ADR) benchmarks set by the ASGE/ACGTF.
• To assess the quality of colonoscopies performed by residents post-curriculum.

Main Methods:

• Prospective analysis of 135 colonoscopies performed by five general surgery residents (postgraduate years 2-3) from 2013-2015.
• Colonoscopies were supervised by experienced endoscopists after residents completed a simulation curriculum.
• Key quality metrics including bowel preparation, cecal intubation rate, ADR, and complications were recorded.

Main Results:

• Adequate bowel preparation was achieved in 90% of cases.
• Cecal intubation was successful in 95% of procedures.
• The overall ADR was 31.8% (exceeding the >25% benchmark), with male ADR at 38.7% and female ADR at 26.0%.

Conclusions:

• General surgery residents, trained via a structured curriculum, can achieve adenoma detection rates consistent with current ASGE/ACGTF quality benchmarks.
• This structured training approach supports resident competency in performing high-quality colonoscopies.