title: Training non-physicians to do endoscopy: Feasibility, effectiveness and cost-effectiveness.
abstract: Colorectal cancer (CRC) is one of the most common cancers in women and men worldwide. Training non-physicians including nurses, nurse practitioners, and physician assistants to perform endoscopy can provide the opportunity to expand access to CRC screening as demand for endoscopic procedures continues to grow. A formal program, incorporating didactic instruction and hands-on practice in addition to oversight, is required to train non-physicians to perform endoscopy as safely and effectively as physicians. Additionally, the context in which the non-physician endoscopy program is organized will dictate key program characteristics including remuneration, participant recruitment and professional and legal considerations. This review explores the evidence in support of non-physician based endoscopy, potential challenges in implementing non-physician endoscopy and requirements for a high-quality program to support training and implementation.
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Ruco
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, SickKids Learning and Research Institutes, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Peadiatrics, University of Toronto, Canada.
authors.forename: C M
authors.initials: CM
authors.lastname: Walsh
authors.affiliation: Thunder Bay Regional Health Sciences Centre, Canada.
authors.forename: M A
authors.initials: MA
authors.lastname: Cooper
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Cancer Care Ontario, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Electronic address: Linda.Rabeneck@cancercare.on.ca.
authors.forename: L
authors.initials: L
authors.lastname: Rabeneck
mesh_terms: D015179:Colorectal Neoplasms / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer; D016099:Endoscopy, Gastrointestinal / Q000191:economics* / Q000193:education*; D005240:Feasibility Studies; D006282:Health Personnel / Q000193:education*; D006801:Humans; D015397:Program Evaluation
keywords: Colorectal cancer screening; Endoscopy; Non-physician