Effect of real-time magnetic endoscope imaging on the teaching and acquisition of colonoscopy skills: results from a single trainee.
OBJECTIVE
Most trainees have little concept of the loops that occur during colonoscopy, and have difficulty in appreciating the combination of withdrawal and torquing manoeuvres that are essential to achieving complete colonoscopy. Real-time magnetic endoscope imaging (MEI) allows visualization of shaft looping, and so makes intuitive the manoeuvres necessary to straighten the colonoscope shaft.


METHODS
Consecutive routine colonoscopies were performed by a single trainee (with previous experience of 15 colonoscopies). Procedures were randomly assigned to be carried out either with the trainee viewing the MEI display, or without the MEI view, which was recorded throughout all examinations.


RESULTS
In total, 71 procedures were performed. To assess the trend for learning, procedures were analysed in blocks of 24 consecutive examinations (periods 1 to 3). In the first 24 procedures (period 1), the number of attempts at straightening the colonoscope and duration of looping were significantly less, and the intubation time was shorter, for examinations performed with the MEI view. In periods 2 to 3, there was a continued trend towards improved performance, but without a significant difference between procedures performed with or without MEI.


CONCLUSIONS
During training, real-time colonoscope imaging using MEI appears to enhance the endoscopist's appreciation of looping and improves the learning of the manoeuvres required to straighten the colonoscope shaft. A prospective, multicentre study assessing a larger number of trainees is needed to clarify these findings.
Shah
S G
SG
Wolfson Unit for Endoscopy, St. Mark's Hospital, London, United Kingdom.
Thomas-Gibson
S
S
Lockett
M
M
Brooker
J C
JC
Thapar
C J
CJ
Grace
I
I
Saunders
B P
BP
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D002983:Clinical Competence; D003113:Colonoscopy / Q000379:methods*; D003952:Diagnostic Imaging; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011336:Probability; D011446:Prospective Studies; D012680:Sensitivity and Specificity