S540 Quality Metrics in Colonoscopy With Fellow Involvement: A Single Center Experience Using New Quality Benchmarks

Introduction: Trainee involvement in endoscopic procedures is crucial in the education of future gastroenterologists. Previous reports of quality metrics in colonoscopy with trainee involvement have been limited and yielded mixed results. This study aims to compare the quality metrics in colonoscopy when GI fellows are involved versus those performed by attending alone using updated colonoscopy quality benchmarks. Methods: This is a single center retrospective review including 7098 colonoscopies performed in 2024. Fellows were involved in 2,464 (34.7%) of these colonoscopies. Metrics including cecal intubation rate (CIR), withdrawal time (WT), adenoma detection rate (ADR), and sessile serrated lesion detection rate (SSLDR) were reported. Categorical variables are summarized as counts and percentages; differences were tested using Chi-square tests. Results: CIR did not significantly differ when a fellow is involved compared to cases where a fellow is not involved (99.9% vs 99.9%, P = 0.733). The updated threshold for WT of ≥8 minutes was achieved more frequently when a fellow was involved (98.2% vs 92.9%, P < 0.001). Both ADR and SSLDR were higher when a fellow was involved (48.2% vs 45.6%, P = 0.043 and 12.1% vs 10.2%, P = 0.019, respectively). Conclusion: These findings suggest GI fellow involvement had an overall positive impact on the updated colonoscopy quality metrics. Specifically, longer withdrawal times and higher detection rates of adenomas and sessile serrated lesions were observed, without negatively impacting cecal intubation rates. The combination of a second observer and longer withdrawal times may contribute to the higher polyp detection rates seen.