Apr 2023

Leading The Way in Improving Colon Cancer Screening

//////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////

Did you know that the Gastrointestinal (GI) Clinic at St. Paul’s Hospital plays an important role in training and evaluating B.C. doctors who perform colonoscopies?

The GI clinic is the training centre for BC Cancer’s Direct Observation of Procedural Skills (DOPS) program and a host centre for Skills Enhancement in Endoscopy (SEE) courses.

Cornerstone of colon screening excellence

The DOPS program is designed to assess a doctor’s technical skills and how they communicate with the patient and other health-care providers involved in the colonoscopy. All doctors in BC who perform screening program colonoscopies are expected to participate in DOPS, a quality improvement initiative of the BC Colon Screening Program. For a DOPS assessment, two trained assessors visit the doctor’s usual clinic or hospital and observe two colonoscopies. The assessors provide feedback, including any areas for improvement.

In 2014, the GI clinic developed the first and only training courses in Canada for doctors interested in becoming DOPS assessors.  Earlier this year, Drs. Robert Enns, Jennifer Telford and the GI clinic team trained seven new year DOPS assessors, bringing the total number in BC to 21. PHC DOPS assessors include Drs. Carl Brown,  Robert Enns,  Ahmer ​Karimuddin, and George Ou.

“A cornerstone of excellence in colon screening in BC, DOPS fosters the standardization of practice and the dissemination of knowledge, leading to improved patient outcomes across the entire province,” says Dr. Scott Cowie, a general surgeon from Langley and DOPS assessor.

Training the trainers 

The GI clinic is also involved in the SEE program, an initiative of the Canadian Association of Gastroenterology and the Canadian Partnership Against Cancer. PHC gastroenterologists Drs. Enns, Telford and Eric Lam  are faculty for the SEE courses and St. Paul’s Hospital is one of two training sites in BC.

SEE consists of two courses: a one-day hands-on Colonoscopy Skills Improvement course, and Train the Colonoscopy Trainer which teaches doctors responsible for training gastroenterology and general surgery residents best practices for colonoscopy training.

“The Colonoscopy Skills Improvement course was invaluable. The new skills I took back to my unit have completely changed the patient experience for the better, and my ability to assess for pre-cancerous growths in the colon has improved significantly,” says Dr. Taralyn Picton, a Kamloops-based gastroenterologist. “The teaching was superb, and I encourage all physicians who do colonoscopy to sign up for the course.”

“The GI clinic team teaches and learns with the training courses,” says Wendy Masinde, clinical nurse leader for the GI clinic.

“Doctors come from other parts of the province to be trained and our doctors visit other centres to assess their peers. Our clinic is a hub for sharing knowledge about how to improve screening, make it more comfortable for patients, and improve detection.

During a training course, the trainer and the learner doctor will be room together, with the learner receiving real time performance enhancing feedback during the procedure. In addition, the other learners are watching the procedure virtually in an adjacent room. Once the procedure is over, additional feedback is shared with the learner doctor.

Improving colonoscopy quality and care throughout B.C.

“I am so appreciative of the GI clinic at St. Paul’s Hospital,” says Laura Gentile, operations director, BC Cancer Screening Programs.

“In addition to performing thousands of colonoscopies a year, they have taken on the additional responsibility of training other physicians to help improve the quality and comfort of colonoscopy throughout the province.”

“The entire team at the GI clinic deserves a huge thank you,” says Dr. Jennifer Telford, medical director for the BC Colon Screening Program and a gastroenterologist with the clinic.

“They are supporting St. Paul’s Hospital as a provincial leader in colonoscopy skills improvement and in training  doctors to be DOPS assessors. This will improve colonoscopy quality throughout the province and help provide British Columbians with equal access to safe, comfortable, and effective colonoscopy.”