Alexander R Ende1, Piet De Groen2, Bryan L Balmadrid3, Joo Ha Hwang3, John Inadomi3, Tomasz Wojtera4, Vladimir Egorov4, Noune Sarvazyan4, Louis Korman5. 1. Division of Gastroenterology, University of Washington School of Medicine, 1959 NE Pacific Street-BB1216, Seattle, WA, 98195, USA. alexende@gmail.com. 2. Division of Gastroenterology, Mayo Clinic College of Medicine, Rochester, MN, USA. 3. Division of Gastroenterology, University of Washington School of Medicine, 1959 NE Pacific Street-BB1216, Seattle, WA, 98195, USA. 4. Artann Laboratories, Trenton, NJ, USA. 5. Metropolitan Gastroenterology Group, Washington, DC, USA.
Abstract
BACKGROUND: Learning to perform colonoscopy safely and effectively is central to gastroenterology fellowship programs. The application of force to the colonoscope is an important part of colonoscopy technique. AIMS: We compared force application during colonoscopy between novice and expert endoscopists using a novel device to determine differences in colonoscopy technique. METHODS: This is an observational cohort study designed to compare force application during colonoscopy between novice and experienced trainees, made up of gastroenterology fellows from two training programs, and expert endoscopists from both academic and private practice settings. RESULTS: Force recordings were obtained for 257 colonoscopies by 37 endoscopists, 21 of whom were trainees. Experts used higher average forward forces during insertion compared to all trainees and significantly less clockwise torque compared to novice trainees. CONCLUSIONS: We present significant, objective differences in colonoscopy technique between novice trainees, experienced trainees, and expert endoscopists. These findings suggest that the colonoscopy force monitor is an objective tool for measuring proficiency in colonoscopy. Furthermore, the device may be used as a teaching tool in training and continued medical education programs.
BACKGROUND: Learning to perform colonoscopy safely and effectively is central to gastroenterology fellowship programs. The application of force to the colonoscope is an important part of colonoscopy technique. AIMS: We compared force application during colonoscopy between novice and expert endoscopists using a novel device to determine differences in colonoscopy technique. METHODS: This is an observational cohort study designed to compare force application during colonoscopy between novice and experienced trainees, made up of gastroenterology fellows from two training programs, and expert endoscopists from both academic and private practice settings. RESULTS: Force recordings were obtained for 257 colonoscopies by 37 endoscopists, 21 of whom were trainees. Experts used higher average forward forces during insertion compared to all trainees and significantly less clockwise torque compared to novice trainees. CONCLUSIONS: We present significant, objective differences in colonoscopy technique between novice trainees, experienced trainees, and expert endoscopists. These findings suggest that the colonoscopy force monitor is an objective tool for measuring proficiency in colonoscopy. Furthermore, the device may be used as a teaching tool in training and continued medical education programs.
Keywords:
Colonoscopy; Education; Force; Quality; Training
Authors: Douglas G Adler; Gennadiy Bakis; Walter J Coyle; Barry DeGregorio; Kulwinder S Dua; Linda S Lee; Lee McHenry; Shireen A Pais; Elizabeth Rajan; Robert E Sedlack; Vanessa M Shami; Ashley L Faulx Journal: Gastrointest Endosc Date: 2011-12-07 Impact factor: 9.427
Authors: Robert E Sedlack; Walter J Coyle; Keith L Obstein; Mohammad A Al-Haddad; Gennadiy Bakis; Jennifer A Christie; Raquel E Davila; Barry DeGregorio; Christoper J DiMaio; Brintha K Enestvedt; Jennifer Jorgensen; Daniel K Mullady; Liz Rajan Journal: Gastrointest Endosc Date: 2013-11-14 Impact factor: 9.427
Authors: Douglas K Rex; Philip S Schoenfeld; Jonathan Cohen; Irving M Pike; Douglas G Adler; M Brian Fennerty; John G Lieb; Walter G Park; Maged K Rizk; Mandeep S Sawhney; Nicholas J Shaheen; Sachin Wani; David S Weinberg Journal: Gastrointest Endosc Date: 2014-12-02 Impact factor: 9.427
Authors: Stephen Thomas Ward; Mohammed A Mohammed; Robert Walt; Roland Valori; Tariq Ismail; Paul Dunckley Journal: Gut Date: 2014-01-27 Impact factor: 23.059