Introduction Endoscopic training for gastroenterology trainees is an integral part of specialty training, with defined competencies required prior to independent practise. Whilst training of future endoscopists is essential to meet the future demands of endoscopy, previous studies have suggested that tolerability and patient satisfaction is decreased when trainees undertake endoscopic examinations. This study evaluates the influence trainees may have on endoscopic tolerability with 3 outcome measures assessed: procedural pain, discomfort and distress.
Methods Consecutive patients attending a tertiary referral centre and undergoing clinically indicated oesophogastroduodenoscopy (OGD) and colonoscopy were prospectively recruited between September 2011 and June 2012. Outcomes measures were assessed using a validated 10-point numeric rating scale (NRS) from 0 (no pain) to 10 (worst pain imaginable), with scores ≥5 considered to be elevated. Details of staff member(s) undertaking endoscopic examinations were recorded, with procedures considered to have trainee involvement if a trainee had performed all or part of the procedure. Chi squared analysis was then used to determine if trainee involvement influenced outcome measures.
Results 610 patients were recruited (280 male, median age 56 years, range 17–90 years). Whilst no significant differences were identified for pain, discomfort or distress during colonoscopy, significant differences were identified in procedural discomfort and distress (p = 0.015 and p = 0.033 respectively) when trainees undertook OGD’s, with procedural pain approaching significance (p = 0.061, Table 1).
Conclusion This is the first study to discriminate pain, distress and discomfort as tolerability outcome measures. Whilst trainee involvement during OGD negatively influenced all 3 outcome measures, no significant effect was observed during colonoscopy. This finding may reflect OGD’s frequently being the first endoscopic procedure taught to trainees and the difficulties of oesophageal intubation.
Disclosure of Interest None Declared
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