Strategies and Educational Approaches to Colonoscopy Training: A Scoping Review.

Abstract

Learning colonoscopy is challenging for inexperienced endoscopists, with competence typically achieved through observation, verbal instruction and hands-on clinical training.<h4>Objective</h4>Various non-clinical teaching models have been developed and are used globally. This scoping review identifies these methods and evaluates their learning outcomes.<h4>Design</h4>Following the PRISMA-ScR framework, MEDLINE and Embase databases were searched for English-language articles published from 2012 onward. Two reviewers screened eligible studies, resulting in a final selection of relevant full-text articles. The review addressed (1) which teaching methods/tools have been tested for endoscopy training and (2) which methods yield better colonoscopy performance outcomes.<h4>Results</h4>From 217 articles, 31 met inclusion criteria. The most common teaching methods were virtual reality (VR) models and physical models, both within and across studies. Other studies included box models, animal models, real-time feedback devices, traditional/verbal instruction models, didactic models and two-person colonoscopy models. Across all studies, participants ranged widely in experience from medical students to experienced specialists, with the effectiveness of training modalities closely tied to the participants' baseline experience.<h4>Conclusion</h4>Despite the variety of colonoscopy teaching methods, there is limited comparative research on their effectiveness both alone and when integrated with the traditional/verbal learning model. Prior experience appears to be a clear predictor of any model's potential effectiveness. As such, it appears important to tailor any colonoscopy training method to a learner's experience level to optimise skill acquisition and clinical readiness. Further research would benefit from a direct comparison of all teaching methods across a range of user skill sets.