A virtual-live hybrid training session is feasible with positive impact on colonoscopy key performance indicators...

Colonoscopy is a complex, operator dependent, practical skill. Attainment of key performance indicators (KPIs) by endoscopists depends primarily upon training. Local factors can lead to unstructured training, contingent upon the observed practice of trainers who may not be consciously competent (understand colonoscopy, can identify and deconstruct problems). We sought to demonstrate the feasibility and impact of a virtuallive colonoscopy-training course.

Trainees underwent a one-day training course (intervention) by physically remote, consciously-competent endoscopists, consisting of interactive theoretical and live sessions, where trainees performed colonoscopy in their local endoscopy unit receiving real-time instructions via a teleconference monitor. KPIs (Caecal intubation rate[CIR], adenoma detection rate[ADR], withdrawal time[WT], Gloucester Comfort Score[GCS] and Visual Analog Scale[VAS]) were assessed on trainee-performed colonoscopies for 3 weeks prior and 4 weeks after the intervention. Qualitative trainee and trainer feedback was obtained.

6 trainees (mean 654 prior colonoscopies) participated performing 60 colonoscopies (33 pre-, 27 post-intervention). Favourable trends in CIR (91% vs 96%, p=0.386), ADR (39% vs 63%, p=0.069) were observed as well as endoscopist-reported GCS>3 (18% vs 11%, p=0.495) and nurse-reported GCS>3 (22% vs 8%, p=0.131). There was good agreement between trainee- and nurse reported GCS and patient reported VAS. Trainees and trainers reported favourable qualitative experiences.

This is the first demonstration of colonoscopy training remotely via teleconference with a positive impact on KPIs. This approach has the potential to create standardized colonoscopy training experiences removing the barriers of travel and allowing exposure to consciously-competent trainers.