A NOVEL ONE-DAY VIRTUAL-LIVE HYBRID TRAINING COURSE IS FEASIBLE AND HAS A POSITIVE IMPACT ON COLONOSCOPY KEY PERFORMANCE INDICATORS OF EXPERIENCED ENDOSCOPY TRAINEES

ABSTRACT

DDW 2022 Author Disclosures Louise Krott NO financial relationship with a commercial interest ;Lynn Debels NO financial relationship with a commercial interest ;Christophe Schoonjans NO financial relationship with a commercial interest ;John Anderson NO financial relationship with a commercial interest ;Roland Valori NO financial relationship with a commercial interest ;Lobke Desomer NO financial relationship with a commercial interest ;David Tate NO financial relationship with a commercial interest Introduction: Colonoscopy is a complex practical skill, which is highly operator dependent. The consistent attainment of key performance indicators (KPIs) by a colonoscopist depends primarily upon training. Local factors, outside of a trainee’s control, may mean their training is unstructured and contingent upon the observed practice of a small number of trainers. This is particularly true given current travel restrictions imposed by the worldwide COVID-19 pandemic. We sought to demonstrate the feasibility and impact of a one-day virtual-live colonoscopy-training course with remote, experienced trainers. Aims and methods: 6 endoscopy trainees [Belgium] underwent a one-day course (the intervention) involving training by consciously competent colonoscopists who were physically remote [United Kingdom]. The intervention comprised 5 interactive sessions on colonoscopy theory combined with 6 live sessions, where trainees performed colonoscopy in their local endoscopy unit, receiving real-time instruction and performance enhancing feedback via a tele-conference monitor situated next to the endoscopic image. Trainers and the five trainees not doing the colonoscopy could follow the procedure in real-time including room view, view of the magnetic colonoscope imager and the endoscopic image. Colonoscopy KPIs were assessed on trainee-performed colonoscopies [unsedated or midazolam/fentanyl sedation] for 3 weeks prior and 4 weeks after the training. Qualitative trainee and trainer feedback regarding the course was obtained. Results: 6 experienced colonoscopy trainees (median 26 months prior-training) underwent the intervention. Trainees performed 60 colonoscopies, (33 pre-, and 27 post-training). Favorable trends in cecal intubation rate (CIR) and adenoma detection rate (ADR) were observed, (91% vs 96% (P=0.386), and 39% vs 63% (P=0.069) respectively). A trend to improved endoscopist-reported comfort scores ([Gloucester Comfort Score (GCS)>3] 18% vs 11% (P=0.375)) and nurse-reported comfort scores (GCS>3 22% vs 8% (P=0.189)) was observed (Table 1). Course participants and trainers alike reported globally favourable qualitative experiences with the expert trainers finding the format feasible and specifically mentioning they could focus on the training without distraction due to reduced cognitive load. Conclusions: Standardization of colonoscopy training is critical to the consistent attainment of KPIs by practicing colonoscopists and improving patient experience. This is the first demonstration of delivering live colonoscopy training remotely an approach acceptable to trainees and trainers that has a positive impact on KPIs. Pending larger studies focused on efficacy, this approach has the potential to create a standardized curriculum for colonoscopy training, removing the barriers of travel, and allowing expanded exposure to consciously-competent expert trainers. [Formula presented]