title: Evaluating changes in gastrointestinal endoscopy training over 5 years: closing the audit loop.
abstract: BACKGROUND
  An audit in 2002 showed that colonoscopy training in a large London training region was poorly structured, with the quality of supervision below recommendations and high reported complication rates. In 2004, the UK National Endoscopy Training Programme introduced centrally funded, accredited courses and new assessment tools to standardize training and raise the quality of colonoscopy by improving the skills of practicing endoscopists.
  
  
  OBJECTIVE
  To evaluate the changes in the standard of colonoscopy training over the last 5 years.
  
  
  METHODS
  Questionnaires used in the earlier study were updated and e-mailed to all gastroenterology trainees in the region and those who participated in the earlier study. Trainees completed and returned the forms electronically.
  
  
  RESULTS
  Twenty-six out of 37 gastroenterology trainees responded (70.3%). Significantly more trainees said that they had been formally taught the principles of colonoscopy (91 vs. 65%; P = 0.02), polypectomy (81 vs. 52%; P = 0.02) and extubation (88 vs. 56%; P = 0.01) than in 2002, and reported that complication rates were lower. Trainers displayed more appropriate teaching strategies and course attendance had significantly increased (84 vs. 48%, P = 0.003). Eighty-seven percent of the trainees thought that their training had been adequate or better than adequate, compared with 25% in 2002.
  
  
  CONCLUSIONS
  In the 2007 survey, trainees reported a significant improvement both in colonoscopy training at base hospitals and in access to specialist courses compared with those in the 2002 survey. The centrally funded training programme has made a significantly positive impact in this large training region that is likely to be reflected elsewhere in England. The loss of such investment may have a detrimental effect on future colonoscopy training and the quality of service provision.
authors.affiliation: Wolfson Unit for Endoscopy, St Mark's Hospital, Imperial College London, Watford Road, Harrow, UK. ahaycock@imperial.ac.uk
authors.forename: Adam V
authors.initials: AV
authors.lastname: Haycock
authors.forename: Jaymin H
authors.initials: JH
authors.lastname: Patel
authors.forename: Paris P
authors.initials: PP
authors.lastname: Tekkis
authors.forename: Siwan
authors.initials: S
authors.lastname: Thomas-Gibson
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003111:Colonic Polyps / Q000601:surgery; D003113:Colonoscopy / Q000592:standards; D003430:Cross-Sectional Studies; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000592:standards; D005762:Gastroenterology / Q000193:education* / Q000592:standards; D017408:Guidelines as Topic; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008131:London; D010465:Perception; D010549:Personal Satisfaction; D015397:Program Evaluation; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors