Colonoscopy completion rates: Should less successful endoscopists be removed or retrained?

doi:10.1136/bmj.329.7477.1287-c

BMJ 2004;329:1287-1288 (27 November), doi:10.1136/bmj.329.7477.1287-c

Letter

Colonoscopy completion rates

Should less successful endoscopists be removed or retrained?

The first 150 words of the full text of this article appear below.

EDITOR—Ball et al report their low colonoscopy completionrates, performing an audit to identify areas for improvement.¹The use of audit in colonoscopy is invaluable and the pointshighlighted are undoubtedly relevant to other colonoscopy units.

The paper notes a considerable interoperator variation in completionrates (34% to 100%). They do not say whether the least successfulcolonoscopists were trainees or consultants, and if trainees,whether they were supervised during the sessions. Surely, removingthe worst performers from colonoscopy without the opportunityof further training or supervised sessions is merely ensuringthat they never have the chance to improve their skills.

The best way to improve performance is through training. Wouldit not have been preferable to educate the worst performers,either by way of attending formal colonoscopy courses or withcolonoscopy sessions supervised by the best performers? Removingthe worst performers from the equation is a quick . . . [Full text of this article]

Christiana Laban, surgical specialist registrar

chrissielaban@yahoo.com

Akil Elewa, associate specialist in surgery

Poole Hospital NHS Trust, Poole, Dorset BH15 2JB

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