Association of Trainee Participation in Colonoscopy Procedures With Quality Metrics.

Area of Science:

• Gastroenterology
• Medical Education
• Clinical Quality Improvement

Background:

• Trainee involvement in colonoscopies is common, but its effect on procedural quality remains unclear due to limitations in previous studies.
• Assessing the impact of trainees on colonoscopy quality is crucial for optimizing patient care and training outcomes.

Purpose of the Study:

• To evaluate the association between trainee participation and key colonoscopy quality indicators.
• To determine if trainee involvement influences adenoma detection rate (ADR) and other polyp detection metrics.

Main Methods:

• A multicenter, population-based cohort study involving 35,499 colonoscopies across 21 hospitals.
• Compared outcomes between procedures with and without trainee involvement, adjusting for potential confounders.
• Key quality metrics included ADR, sessile serrated polyp detection rate (ssPDR), polyp detection rate (PDR), cecal intubation rate (CIR), and perforation rate.

Main Results:

• No significant differences were observed in ADR, CIR, or perforation rates between procedures with and without trainees.
• Sessile serrated polyp detection rate (ssPDR) and overall polyp detection rate (PDR) were significantly lower in procedures involving trainees.
• After adjustment, ADR, PDR, and CIR were not associated with trainee participation, but ssPDR remained significantly lower.

Conclusions:

• Trainee participation in colonoscopies is associated with a reduced sessile serrated polyp detection rate.
• Other colonoscopy quality measures, including adenoma detection, were not significantly affected by trainee involvement.
• Increased vigilance during right colon examination may be warranted when trainees are involved in colonoscopies.