Advertisement

Digestive Diseases and Sciences

, Volume 63, Issue 1, pp 46–52 | Cite as

Objective Differences in Colonoscopy Technique Between Trainee and Expert Endoscopists Using the Colonoscopy Force Monitor

  • Alexander R. Ende
  • Piet De Groen
  • Bryan L. Balmadrid
  • Joo Ha Hwang
  • John Inadomi
  • Tomasz Wojtera
  • Vladimir Egorov
  • Noune Sarvazyan
  • Louis Korman
Original Article

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.

Keywords

Colonoscopy Education Training Force Quality 

Notes

Acknowledgments

Research reported in this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number R44DK068936. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interest.

References

  1. 1.
    ASGE Training Committee, Adler DG, Bakis G, et al. Principles of training in GI endoscopy. Gastrointest Endosc. 2012;75:231–235.CrossRefGoogle Scholar
  2. 2.
    Training Committee 2010–2011, Sedlack RE, Shami VM, et al. Colonoscopy core curriculum. Gastrointest Endosc. 2012;76:482–490.CrossRefGoogle Scholar
  3. 3.
    Rex DK, Schoenfeld PS, Cohen J, et al. Quality indicators for colonoscopy. Gastrointest Endosc. 2015;81:31–53.CrossRefPubMedGoogle Scholar
  4. 4.
    Sedlack R. Assessing fellow skills: practice what you preach, measure what you teach. Gastrointest Endosc. 2015;81:1425–1426.CrossRefPubMedGoogle Scholar
  5. 5.
    Benson M, Lucey M, Pfau P. Training the competent colonoscopist. Gastroenterology. 2014;147:708–709.CrossRefPubMedGoogle Scholar
  6. 6.
    ASGE Training Committee, et al. ASGE’s assessment of competency in endoscopy evaluation tools for colonoscopy and EGD. Gastrointest Endosc. 2014;79:1–7.CrossRefGoogle Scholar
  7. 7.
    Sedlack RE. Training to competency in colonoscopy: assessing and defining competency standards. Gastrointest Endosc. 2011;74:e1–e2.CrossRefGoogle Scholar
  8. 8.
    Park HJ, Hong JH, Kim HS, et al. Predictive factors affecting cecal intubation failure in colonoscopy trainees. BMC Med Educ. 2013;13:5.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Ward ST, Mohammed MA, Walt R, et al. An analysis of the learning curve to achieve competency at colonoscopy using the JETS database. Gut. 2014;63:1746–1754.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Koch AD, Haringsma J, Schoon EJ, de Man RA, Kuipers EJ. Competence measurement during colonoscopy training: the use of self-assessment of performance measures. Am J Gastroenterol. 2012;107:971–975.CrossRefPubMedGoogle Scholar
  11. 11.
    Sedlack RE, Coyle WJ, ACE Research Group. Assessment of competency in endoscopy: establishing and validating generalizable competency benchmarks for colonoscopy. Gastrointest. Endosc. 2015.  https://doi.org/10.1016/j.gie.2015.04.041.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Alexander R. Ende
    • 1
  • Piet De Groen
    • 2
  • Bryan L. Balmadrid
    • 1
  • Joo Ha Hwang
    • 1
  • John Inadomi
    • 1
  • Tomasz Wojtera
    • 3
  • Vladimir Egorov
    • 3
  • Noune Sarvazyan
    • 3
  • Louis Korman
    • 4
  1. 1.Division of GastroenterologyUniversity of Washington School of MedicineSeattleUSA
  2. 2.Division of GastroenterologyMayo Clinic College of MedicineRochesterUSA
  3. 3.Artann LaboratoriesTrentonUSA
  4. 4.Metropolitan Gastroenterology GroupWashingtonUSA

Personalised recommendations