Practice makes perfect for colonoscopies

Surgeons should perform 140 colonoscopies before their competency is assessed, U.S. researchers say. Dr. Robert E. Sedlack of the Mayo Clinic in Rochester, Minn., and his research team suggest much more practice is needed than gastroenterological professional societies recommend. "Current recommendations are that 140 procedures should be done before attempting to assess competency, but with no set recommendations on how to assess it," Sedlack says in a statement. "Our findings suggest that it takes an average of 275 procedures for a gastroenterology fellow to reach minimal cognitive and motor competency." The research team assessed the performance of 41 Mayo Clinic gastroenterology fellows who performed more than 6,600 colonoscopies in Rochester from July 2007 to June 2010, using the validated testing method, the Mayo Colonoscopy Skills Assessment Tool. "The MCSAT is the first such tool for providing detailed assessment of the core cognitive and motor skills of trainees in this procedure," Sedlack says. "As a result of our use of this test, we have been able to define learning curves and minimal competency benchmarks to identify when trainees are ready to operate independently." The findings may have particular significance for specialties other than gastroenterology because gastroenterology fellows may perform well more than 400 colonoscopies during their training, but specialists in other areas, such as surgery or family practice, may perform significantly fewer procedures during their training. Sedlack is presenting the findings at Digestive Disease Week conference in Chicago.