Background and aims: Poor standards in colonoscopy services and the introduction of a colorectal cancer
screening program in the United Kingdom have highlighted the need to establish high-quality
training and competency assessments in colonoscopy. The aims of this study were to
evaluate the effectiveness of a 1-week hands-on colonoscopy course utilizing novel
assessment tools.
Methods: Twenty-one doctors with varying colonoscopy experience who attended an accelerated
colonoscopy training week (ACTW) were prospectively studied. They were trained and
assessed in key aspects of colonoscopy. Knowledge was assessed with a multiple choice
question (MCQ) paper. Practical hand skills were taught and evaluated using a computer
simulator and live case teaching. Actual colonoscopy performance was assessed using
Direct Observation of Procedural Skills scores (DOPS) and an objective tri-split video
score of insertion technique. Two independent trainers taught and assessed the trainees
at the start and end of the ACTW and at a median of 9 months’ follow-up.
Results: Following training there were significant improvements in the MCQ score (P < 0.001), the simulator test case times (P = 0.02, P = 0.003), and the global DOPS score (P ≤ 0.02). All improvements following the accelerated training were sustained at a
median follow-up of 9 months.
Conclusions: This study is the first in the literature to describe the positive, sustained impact
of an intensive hands-on colonoscopy training course. Measurements of performance
in key areas of skill acquisition improved following training.
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S. Thomas-Gibson, MD
Wolfson Unit for Endoscopy
St. Mark’s Hospital
Northwick Park
Watford Road
Harrow
Middlesex
HA1 3UJ
UK
Fax: +44-208-4233588
Email: siwan@doctors.org.uk