BACKGROUND: Recently, it has been suggested that nurses can perform diagnostic endoscopy procedures, which traditionally have been a physician's responsibility. The existing studies concerning quality of sigmoidoscopy performed by nurses are small, used assessment tools with insufficient validation and to date there is very little knowledge of the learning curve patterns for physicians and nurses. The aim of a present study was to assess early learning curves on a virtual-reality colonoscopy simulator of untrained residents as compared with that of nurses with and without endoscopy assistance experience. MATERIALS AND METHODS: Thirty subjects were included in the study: 10 female residents (median age 30.5 years) without colonoscopy experience, 10 female nurses (median age 27.5 years) without endoscopy assistance experience and 10 female nurses (median age 42 years) with endoscopy assistance experience. All participants performed 10 repetitions of task 6 from the "Introduction" colonoscopy module of the Accu Touch Endoscopy simulator. Eight experienced colonoscopists performed three repetitions of task 6 in order to provide the reference expert level of performance. RESULTS: All subjects completed the virtual colonoscopy without complications. Significant differences existed between residents and nurses with respect to time to complete the procedure. Residents and nurses showed similar learning curve patterns. There were not significant differences between the groups in terms of volume of insufflated air, percentage of time without discomfort, and percentage of mucosa seen. None of the trainee groups achieved expert proficiency level in terms of time and amount of insufflated air by the tenth repetition. CONCLUSIONS: Nurses performed virtual colonoscopy as accurately and safely as residents. Although the residents performed significantly faster, time differences showed a tendency towards decreasing, and appraisement of the numeric time differences seemed of minor practical importance. From a technical point of view this indicates that nurses may learn to perform colonoscopy after appropriate training.
BACKGROUND: Recently, it has been suggested that nurses can perform diagnostic endoscopy procedures, which traditionally have been a physician's responsibility. The existing studies concerning quality of sigmoidoscopy performed by nurses are small, used assessment tools with insufficient validation and to date there is very little knowledge of the learning curve patterns for physicians and nurses. The aim of a present study was to assess early learning curves on a virtual-reality colonoscopy simulator of untrained residents as compared with that of nurses with and without endoscopy assistance experience. MATERIALS AND METHODS: Thirty subjects were included in the study: 10 female residents (median age 30.5 years) without colonoscopy experience, 10 female nurses (median age 27.5 years) without endoscopy assistance experience and 10 female nurses (median age 42 years) with endoscopy assistance experience. All participants performed 10 repetitions of task 6 from the "Introduction" colonoscopy module of the Accu Touch Endoscopy simulator. Eight experienced colonoscopists performed three repetitions of task 6 in order to provide the reference expert level of performance. RESULTS: All subjects completed the virtual colonoscopy without complications. Significant differences existed between residents and nurses with respect to time to complete the procedure. Residents and nurses showed similar learning curve patterns. There were not significant differences between the groups in terms of volume of insufflated air, percentage of time without discomfort, and percentage of mucosa seen. None of the trainee groups achieved expert proficiency level in terms of time and amount of insufflated air by the tenth repetition. CONCLUSIONS: Nurses performed virtual colonoscopy as accurately and safely as residents. Although the residents performed significantly faster, time differences showed a tendency towards decreasing, and appraisement of the numeric time differences seemed of minor practical importance. From a technical point of view this indicates that nurses may learn to perform colonoscopy after appropriate training.
Authors: Jonathan Cohen; Seth A Cohen; Kinjal C Vora; Xiaonan Xue; J Steven Burdick; Simmy Bank; Edmund J Bini; Henry Bodenheimer; Maurice Cerulli; Hans Gerdes; David Greenwald; Frank Gress; Irwin Grosman; Robert Hawes; Gerard Mullin; Gerard Mullen; Felice Schnoll-Sussman; Anthony Starpoli; Peter Stevens; Scott Tenner; Gerald Villanueva Journal: Gastrointest Endosc Date: 2006-09 Impact factor: 9.427
Authors: P Schoenfeld; S Lipscomb; J Crook; J Dominguez; J Butler; L Holmes; D Cruess; D Rex Journal: Gastroenterology Date: 1999-08 Impact factor: 22.682
Authors: Jason Park; Helen MacRae; Laura J Musselman; Peter Rossos; Stanley J Hamstra; Stephen Wolman; Richard K Reznick Journal: Am J Surg Date: 2007-08 Impact factor: 2.565