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127 IMPACT OF RESIDENT TRAINING ON COLONOSCOPY PROCEDURE TIME A Lazarescu, WT Depew AIM: Trainees in endoscopy usually require longer time intervals per procedure than attending endoscopists. The magnitude and impact of such time effects on endoscopy services have not been systematically appraised. This study measures colonoscopy procedure times with and without trainees and provides insight into the impact of training on service delivery.
Gastrointestinal Diseases Research Unit, Hotel Dieu Hospital, Division of Gastroenterology, Queen's University School of Medicine, Kingston, Ontario
METHODS: The time to perform colonoscopy was determined from individual endoscopy records which identify the start and stop times to the nearest minute. The data was retrieved from an electronic database for a 12 month period (2005-2006). Procedure time (PT) was defined as the interval from initiation of a successful intravenous access in the endoscopy room (TI) to final extubation (TE). PTs were compared by ANOVA and post hoc independent samples tests (SPSS v 12.0).
RESULTS: 1977 colonoscopy examinations were performed over the one-year period. 1304 examinations were carried out by 7 attendings alone with no trainees. 578 examinations were performed by trainees; 2 junior GI fellows (R1, 157), 2 senior GI fellows (R2, 322) and 3 surgical residents (S, 99). Mean PT without trainees was 35 ± 15 minutes. For trainees PT was significantly longer (for R1 = 53 ± 24 minutes, for R2 = 49 ± 19 minutes, for S = 51 ± 18 minutes) (ANOVA, P<0.001). No significant difference was observed among the 3 trainee groups. The relative increase in PT ranged from 40% to 51%.
CONCLUSIONS: The duration of colonoscopy was significantly increased with the involvement of trainees. The level (in years) of training or type of trainee did not influence PT. The impact of training on service volume and physician resources is substantial and must be considered in the global operational details of a teaching facility. It is also relevant to clinical benchmarks related to funding models.