Sigmoidoscopy training for nurses and resident physicians

Five gastrointestinal nurses (three licensed practical nurses and two registered nurses) and five resident physicians were enrolled in a sigmoidoscopy training protocol. Patients referred for a screening sigmoidoscopy were randomized to have the procedure performed by a nurse or a resident. Objective criteria for proficiency were depth of endoscope insertion, procedure time, and identification of anatomic landmarks and pathologic lesions; subjective criteria included thoroughness and the need for assistance. Four nurses and all of the residents were deemed proficient at a mean of 20 procedures in both groups. One registered nurse did not achieve proficiency after 35 procedures; this determination was based on subjective criteria. Insertion depth and identification of normal anatomy improved with experience. Trainees missed 1.4% of pathologic lesions, and no complications were observed. Nurses can be trained to perform a screening sigmoidoscopy in a safe and effective manner, with results similar to those for doctors.