Do "hands-on" training courses in flexible sigmoidoscopy impact the practice patterns of primary care physicians?

P. I. Okolo, G. T. Gislason, M. Bedine, A. N. Kalloo

Research output: Contribution to journalArticlepeer-review


"Hands-on" courses may be an important adjunctive training tool for teaching flexible sigmoidoscopy (flex sig). There are no data on the impact of these courses on actual practice patterns. In order to determine if attendance at a "hands-on" flex sig course was predictive of performing flex sig in a primary care practice, we compared primary care providers (PCPs) who had completed a hands-on training course to PCPs who had not. Methods: Using a simple sampling frame, we randomly surveyed PCPs 2-3 years after they had attended a "hands-on" flex sig course at our institution. A random sample of Maryland PCPs who had never attended a "hands-on" flex sig course served as controls. Data were obtained about routine flex sig practice, numbers of flex sigs/month, demographic data, practice type and setting, managed care organization (MCO) penetration > 50% and training after the course to achieve competence. Multivariate analysis was performed using logistic regression analysis. Results: 30 course participants and 25 control PCPs were surveyed. The two groups had similar demographic patterns. Course participants were more likely to routinely perform flex sigs in their practices (OR 3.69 [95% CI 1.11, 12.25]) and performed more procedures. (4.33 ± 1.17 vs. 1.4 ± 0.86 per month) (P < 0.05). 95% of all PCPs who attended the course and were performing flex sigs routinely had additional training with a local gastroenterologist as recommended by the course. Pre-course performance of flex sigs, MCO penetration, practice type and practice location (rural vs. urban) were not significant predictors of routine flex sig. practice, however, they improved the overall predictability of the logistic model. After adjusting for these confounders, the odds of routinely performing flex sigs were 5.00 times greater in the course participants than in controls. Conclusion: Participation in a hands-on-course is a significant predictor of performing flex sig in a primary care practice and appears to a useful training adjunct for teaching this screening procedure.

Original languageEnglish (US)
Pages (from-to)AB57
JournalGastrointestinal endoscopy
Issue number4
StatePublished - 1998

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology


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