Establishing proficiency in flexible sigmoidoscopy in a family practice residency program.

BACKGROUND AND OBJECTIVES

Fiberoptic flexible sigmoidoscopy (FFS) is widely used by family physicians to evaluate abdominal problems and screen for colorectal cancer. We evaluated data on exams performed by family practice residents to determine the number of supervised procedures needed for technical proficiency at FFS.

METHODS

We reviewed data recorded from all FFS procedures done at a family practice residency from October 1986-July 1994.

RESULTS

A total of 262 exams were performed by 55 residents at the Family Practice Center. There was modest correlation between increasing numbers of exams and increased unassisted depth of insertion (UDI). Maximum UDI was achieved after 10-15 supervised exams. Factors such as patient gender, prior surgery, and preparation quality were also significantly correlated with UDI. Significant differences in training experience and patient selection were seen between male and female residents.

CONCLUSIONS

Maximal UDI is reached after 10-15 procedures. Differences in training experiences and successful UDI based on resident gender should be studied further.