Flexible sigmoidoscopy: primary care outcomes after two types of continuing medical education

The office impact of two types of continuing medical education on flexible sigmoidoscopy were compared. Measured office outcomes included sigmoidoscopy utilization rates, depth of insertion, time required to perform the procedure, biopsy rates, acquisition of further training, use of electrocautery, performance of polypectomy, complication rates, and general satisfaction with office flexible sigmoidoscopy. A matched control group was randomly selected and polled for previous flexible sigmoidoscopy continuing medical education and current flexible sigmoidoscopy utilization. Outcomes as they relate to different types of course design were discussed and compared. Procedure times and depth of insertion were comparable to published studies from tertiary care centers. In the faculty intensive course, trainees utilized less procedure time for their initial 10-20 procedures. Attitudes in practice were positive with 68% of all physicians performing biopsy. A 60-cm scope length was chosen by 87% of physicians. Physicians in faculty intensive courses were more likely to obtain additional training and less likely to initiate higher risk procedures such as electrocautery, polypectomy, and colonoscopy.