Outcomes following continuing medical education on flexible sigmoidoscopy

Ninety-four out of 114 physicians who took part in a continuing medical education course on flexible sigmoidoscopy were contacted 12 to 18 months later. Ninety per cent (85) were now using flexible sigmoidoscopy in their office practice. Complete demographic and procedure-outcome information (number of procedures performed, average depth of insertion, time required for procedure, complications) was acquired from 78 of these physicians. Using a randomly chosen comparison group of 87 physicians matched for sex and specialty, the likelihood of similar continuing medical education during the study period was obtained. Thirty-two physicians had obtained this training and 69% (22 of 32) currently used flexible sigmoidoscopy. Utilization of the method was 9% (four of 45) among physicians who had not obtained this continuing education. Continuing medical education was significantly associated (P less than 0.05) with the acquisition and utilization of flexible sigmoidoscopy. The study group reported 5467 procedures, resulting in one bowel perforation. The utilization of sigmoidoscopy in primary care was significantly greater (P less than 0.05) in the post-continuing education period. After 10 to 20 procedures, insertion depths and procedure times were similar to those reported in other published primary care series.