P4084 - The Link Between Trainee Participation in Colonoscopy Procedures and Quality Metrics

Mehak Bassi, MD¹, Archit Garg, MD¹, Beatriz Gros Alcade, MD², Aadhithyaraman Santharaman, MD³, Khyati Bidani, MD⁴, Richa Rani, MD⁴, Mannat Kaur Bhatia, MD⁵, Babu Mohan, MD⁶, Arkady Broder, MD^1
1Saint Peter's University Hospital, New Brunswick, NJ; ²Reina Sofia University Hospital, Cordoba, Andalucia, Spain; ³Saint Peter's University Hospital/Robert Wood Johnson, New Brunswick, NJ; ⁴Saint Peter’s University Hospital, New Brunswick, NJ; ⁵Saint Peter's University Hospital/Robert Wood Johnson Hospital, New Brunswick, NJ; ⁶Orlando Gastroenterology PA, Orlando, FL

Introduction: Sessile serrated polyps, precursors to about one-third of colorectal cancers, are often missed due to their indistinct borders compared to tubular adenomas. The Serrated Polyp Detection Rate (SDR) is around 5.1% and is increasingly recognized as a key quality indicator for colonoscopy.
While many studies focus on adenoma detection rates by the training year of gastrointestinal fellows, research on detecting sessile serrated lesions during a three-year fellowship is limited. Our objective was to compare the detection rates of sessile serrated lesions (SDR) and conventional adenomas (ADR) across different stages of gastroenterology training.

Methods: We reviewed 1,603 screening colonoscopies (median age 57; 59.4% women) at our institute. Fourteen GI fellows performed 1,025 colonoscopies (63.9%): 201 (12.5%) by first years (F1s), 387 (24.1%) by second years (F2s), and 428 (26.7%) by third years (F3s).

Results: The overall SDR was 4.0%, and ADR was 46% in colonoscopies performed by attending physicians with fellows.
When comparing different years of training (Table 1), no significant differences in SDR were found among F1s, F2s, and F3s (3.5% vs. 4.1% vs. 5.6%, p=0.419). However, ADR was higher in F2s compared to F1s (50.9% vs. 42.3%, p=0.036) and in F3s compared to F1s (42.8% vs. 42.3%, p=0.036). There were no differences in the overall polyp detection rate (tubular adenoma, sessile serrated, and hyper-plastic polyps).
When comparing polyp detection rates by months of training (every six months and beyond), no significant differences were noted in ADR (46.0 vs. 39.2 vs. 50.0 vs. 50.6 vs. 42.3 vs. 44.5, p=0.276) or overall polyp detection rate (63.9 vs. 65.0 vs. 72.2 vs. 72.1 vs. 69.0 vs. 69.9, p=0.590), Figure 1. Similarly, no differences were noted in SDR between different months of training (4.0% vs. 2.9% vs. 3.6% vs. 6.0% vs. 5.0% vs. 6.1%, p=0.730).

Discussion: Our ADR exceeded the national benchmark, but our SDR fell below the recommended quality standard. The overall polyp detection rates and SDR do not show significant variations by year or months of training. Although there is some improvement in specific skills with experience (as seen with ADR in F2s), the overall detection abilities for polyps and sessile serrated remain relatively stable throughout the training period. It may be attributed to the challenges in detecting these lesions, even for board-certified endoscopists. It is imperative that training during fellowship should emphasize correctly detecting serrated lesions.



Disclosures:


Mehak Bassi, MD¹, Archit Garg, MD¹, Beatriz Gros Alcade, MD², Aadhithyaraman Santharaman, MD³, Khyati Bidani, MD⁴, Richa Rani, MD⁴, Mannat Kaur Bhatia, MD⁵, Babu Mohan, MD⁶, Arkady Broder, MD¹. P4084 - The Link Between Trainee Participation in Colonoscopy Procedures and Quality Metrics, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.