title: Trainee colonoscopists fulfil quality standards for the detection of adenomatous polyps.
abstract: BACKGROUND
  The detection of adenomatous lesions is a major indicator for quality and competence in colonoscopy. Little is known about adenoma detection rates (ADR) of endoscopy trainees. The aim of our study was to investigate the performance of trainee colonoscopists in detecting adenomas and to depict the shape of adenoma detection learning curves during apprenticeship.
  
  
  METHODS
  We retrospectively investigated a prospectively maintained database of a single tertiary referral center to reveal colonoscopies performed by trainee endoscopists during 2001 and 2013. Colonoscopy reports were chronologically retrieved and separately analyzed for each trainee. Using cumulative curves, courses of trainee's Adenoma detection rates (ADR) during apprenticeship were displayed. Additionally, procedural data including cecal intubation rate and occurrence of complications were assessed.
  
  
  RESULTS
  We retrospectively analyzed 4354 colonoscopies conducted by 10 trainee endoscopists (TE). A median number of 371 investigations were performed by each apprentice. Group ADR was 23%. No significant difference between aggregated ADRs at the beginning (23%) and at the end (22%) of apprenticeship could be determined (p = 0.70). However, individual learning curves showed considerable different slopes. Personal ADR values ranged between 17% and 31%. Overall cecum intubation rate was 99.0 %. Complication rates were low and fulfilled quality requirements recommended in guidelines.
  
  
  CONCLUSIONS
  From the beginning of education, trainee colonoscopists are capable to provide high-quality investigations considering the detection of adenomas as a benchmark quality indicator. Nevertheless, performance differs markedly between investigators. Therefore, individual detection rates should be reviewed regularly to reveal further need for training.
authors.forename: Peter
authors.initials: P
authors.lastname: Klare
authors.forename: Stefan
authors.initials: S
authors.lastname: Ascher
authors.forename: Stefan
authors.initials: S
authors.lastname: Wagenpfeil
authors.forename: Daniel
authors.initials: D
authors.lastname: Rapp
authors.forename: Monther
authors.initials: M
authors.lastname: Bajbouj
authors.forename: Bruno
authors.initials: B
authors.lastname: Neu
authors.forename: Roland M
authors.initials: RM
authors.lastname: Schmid
authors.forename: Stefan
authors.initials: S
authors.lastname: von Delius
mesh_terms: D018256:Adenomatous Polyps / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence / Q000592:standards*; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003113:Colonoscopy / Q000193:education*; D004503:Education, Medical, Graduate; D005260:Female; D005762:Gastroenterology / Q000193:education*; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult