Colonoscopy training--new approaches, old problems.

Colonoscopy traditionally has been taught using the apprenticeship approach. Assessment of competence has been, at best, informal and based largely on the number of procedures trainees have performed. The advent of colorectal cancer screening has demanded formalization of training and assessment using structured teaching and state-of-the-art training tools, such as computer simulation. New-generation approaches and technology have the ability to raise the standard of coloscopy provided by competent practitioners.