Colonoscopy with Attention, Reliability and Excellence-The CARE Project

The success of a colonoscopy is highly dependent on the adequacy of bowel preparation. International guidelines recommend good bowel preparation in at least 90% of procedures, as measured by the Boston Bowel Preparation Scale. A quality review at our center revealed 25.7% of colonoscopies had inadequate preparation, which formed the needs basis for our intervention.

We implemented a simulation-based educational intervention to improve healthcare workers' (HCWs) knowledge and confidence regarding colonoscopy preparation. The program included an interactive teaching session covering the essentials of bowel preparation, counseling stations with simulated patients with common clinical presentations, followed by debriefing using the Plus-Delta model. Participants completed pre- and post-intervention tests to assess knowledge improvement and a self-efficacy questionnaire evaluating confidence in key aspects of colonoscopy preparation. A postintervention chart review was conducted to assess the impact of the exercise.

Twenty-eight gastroenterology HCWs participated. The mean pretest score increased from 58.6% to 75.7% (p < .05). Self-efficacy scores improved from 39.1 (71.1%) to 51.0 (92.8%) (p < .05). Qualitative feedback was overwhelmingly positive. A postintervention clinical review after 12 weeks demonstrated significant improvement in bowel preparation quality, with adequate preparation increasing to 92.8%(p < .05).

A simulation-based intervention was successful in an interprofessional healthcare cohort of HCWs in improving counseling skills, participant confidence and quality of clinical care through a measurable improvement in bowel preparation quality.