VAGLAHS, David Geffen School of Medicine at UCLA North Hills, CA
Felix W. Leung, MD; VAGLAHS, David Geffen School of Medicine at UCLA, North Hills, CA
Introduction: Air insufflation is the conventional method that trainees learn to perform colonoscopy. In the absence of alternatives, it is not surprising that there is no data to reflect on trainees' experience. Emerging RCT data indicated that water exchange (WE) reduced insertion pain and increased adenoma detection. Since WE maneuvers are drastically different from those with air insufflation, there is concern that trainees may view the new method less favorably for learning. The author has been teaching both methods to trainees since 2016. This retrospective review of prospectively collected data addresses the trainees' reflection on being taught both methods. We test the hypothesis that compared with being taught air insufflation the trainees would show less favorable responses to two statements. 1. I am confident with my technical skills using this method of colonoscopy; 2. My colonoscopy experience was better than expected. Methods: In teaching the WE method, the author emphasizes near-complete removal of infused water during insertion, although trainees were more accustomed to air insufflation taught by other trainers. Trainees with some experience with air insufflation and no experience with WE colonoscopy received training by the author. After each procedure they responded to two statements using a number in a scale with 1 (strongly agree) to 5 (strongly disagree). The statements were 1. I am confident with my technical skills using this method of colonoscopy. 2. My colonoscopy experience was better than expected. IRB approval was waved for educational assessment. Results: From 2016 to 2020, 171 consecutive evaluations (102 WE and 69 air insufflation) were prospectively collected. Table 1 shows the trainees' evaluations. The trainees were equally confident with their technical skill with air insufflation or WE training (P=0.4934). They found their experience in performing WE was slightly but significantly (P=0.0451) better than expected compared with air insufflation. Discussion: The trainees showed similar confidence with their technical skills using air insufflation and WE method of training. Contrary to the initial hypothesis, the trainees found the WE method experience was slightly but significantly better than expected compared with the air insufflation experience. The favorable impression with WE as a tool for training suggests that WE is acceptable to the trainees despite the increased complexity compared with air insufflation.
Trainee evaluations of being taught air insufflation or water exchange.
Disclosures: Felix Leung indicated no relevant financial relationships.