P24: Improving colonoscopy quality through effective training

Lasse Pedersen1, Inge Bernstein1, Karen Lindorff-Larsen2.

1 – Aalborg University Hospital, Department of Surgery. 2 – Aalborg University Hospital, NordSim.


There is a correlation between Adenoma Detection Rate (ADR) and missed cancers. The effect of surveillance colonoscopies is dependent on optimal ADR, low complication rates and a high degree of compliance. A refined technique with minimal discomfort is essential.

In Denmark surgeons traditionally perform screening colonoscopy. Surgical training programs, however, pay little attention to colonoscopy. There is an option to train on simulators, but clinical supervision is often minimal, leading to self-taught techniques.


A project oriented approach to improve quality at multiple levels including consensus on technique, training programs for both trainers and trainees and exploration of the patient’s perspective. We initiated a program for trainees with a personally assigned trainer and progress evaluation using direct observation and simulator test cases. Specialists were required to participate in a trainers’ program to be eligible as supervisors.


The training programs are successfully running. Data on learning curves, patient experience and essential quality parameters are pending analysis.


Optimal colonoscopy technique is critical for the outcome of surveillance. Insufficient attention has been paid to colonoscopy training. We aim to remedy this, and to measure the effect on essential quality parameters before and after the intervention.