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Related Experiment Videos

Technical proficiency of trainees performing colonoscopy: a learning curve

J B Marshall1

  • 1Division of Gastroenterology, University of Missouri School of Medicine, Columbia 65212, USA.

Gastrointestinal Endoscopy
|October 1, 1995
PubMed
Summary

Technical proficiency in colonoscopy improves with experience, with second-year fellows significantly outperforming first-year trainees in reaching the cecum. This suggests competency thresholds may need reevaluation based on objective performance measures.

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Area of Science:

  • Gastroenterology
  • Medical Education
  • Surgical Skills Training

Background:

  • Gastroenterology (GI) fellows undergo supervised colonoscopy training over two years.
  • Objective measures are needed to assess technical progress in colonoscopy skills.

Purpose of the Study:

  • To objectively measure the technical progress of trainees learning colonoscopy.
  • To evaluate the learning curve for reaching the cecum within a defined time.

Main Methods:

  • Assessed the frequency of fellows reaching the cecum in under 30 minutes.
  • Data collected during the last 7 months of the first and second years of fellowship.
  • Compared fellow performance to an experienced endoscopy instructor.

Main Results:

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  • First-year fellows achieved a 54% cecal intubation rate; second-year fellows achieved 86%.
  • Experienced instructor achieved 97% cecal intubation rate.
  • First-year fellows overestimated cecal intubation in 5.7% of cases, a discrepancy absent in second-year fellows.

Conclusions:

  • Colonoscopy proficiency, particularly cecal intubation, increases with procedural experience.
  • Individual learning rates vary, and skill development may continue post-formal training.
  • The suggested American Society for Gastrointestinal Endoscopy (ASGE) minimum of 100 procedures for competency may be insufficient.