{
  "abstract": "Background Colonoscopy completion is a key quality indicator. Although Joint Advisory Group (JAG) guidance supports supervised trainee involvement, concerns persist that training may adversely affect completion, efficiency, patient comfort, or procedural safety during service delivery.Aim To assess the association between trainee involvement and diagnostic colonoscopy completion, with secondary analysis of procedural efficiency, sedation use, patient comfort, and complications.Methods We performed a retrospective multicentre analysis of diagnostic colonoscopies recorded in EndoVault across 3 South Yorkshire hospitals over a five-year period. Completion was defined as successful intubation of the caecum. Outcomes were compared between procedures performed with and without trainee involvement using univariable and multivariable analyses.Results A total of 32,088 diagnostic colonoscopies were analysed (52.7% female; median age 61 years, IQR 49–71), of which 2,571 (8.0%) involved a trainee. Completion rates were higher when a trainee was present compared with procedures performed by an independent endoscopist alone (93.9% vs 91.1%, p<0.001). There was no difference in procedure duration (median 13.0 vs 13.0 minutes, p=0.37) or patient-reported discomfort (p=0.60). Complications were rare, with five events recorded in procedures without trainee involvement and none when a trainee was present; given the very low event rate, no statistically significant difference was observed. Sedation was used more frequently in trainee-involved procedures; midazolam (36.9% vs 33.6%, p<0.001) and fentanyl (38.5% vs 35.5%,p=0.002). however, mean doses of midazolam and fentanyl did not differ significantly (mean 56.0mcg, SD 19.0 vs 55.2mcg, SD 19.3mcg, p<0.001).Conclusion Supervised trainee involvement in diagnostic colonoscopy does not adversely affect key quality indicators and is associated with slightly higher completion rates. This finding likely reflects enhanced supervision and trainer intervention during complex cases. These results support current JAG-endorsed training models and provide reassurance that high-quality outcomes can be maintained alongside trainee progression.",
  "authors": [
    {
      "affiliations": [
        "Sheffield Teaching Hospital, Sheffield, United Kingdom",
        "Department of Gastroenterology, Doncaster Royal Infirmary, Doncaster, UK"
      ],
      "name": "Kennedy Edwards"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Doncaster Royal Infirmary, Doncaster, UK"
      ],
      "name": "Niamh Louwman"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Doncaster Royal Infirmary, Doncaster, UK",
        "Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield, UK"
      ],
      "name": "Suneil A Raju"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Doncaster Royal Infirmary, Doncaster, UK"
      ],
      "name": "Sampath Kumar"
    }
  ],
  "title": "FP42 Does supervised trainee involvement affect diagnostic colonoscopy outcomes? A multicentre UK study",
  "uid": "fa3d9b81-8366-5397-8767-1dd39f25d5a3"
}