Do all trainers think the same? Exploring use of the Think Aloud method to understand colonoscopy trainer thought processes.

Background and study aims: Colonoscopy is a complex skill to teach. Understanding trainer cognition is an important factor in determining the level of trainer competence. This study aimed to explore colonoscopy trainer thoughts as they observed trainee performance using the Think Aloud method (TA).

Methods: Eleven trainers verbalized their thoughts (TA) while watching three video recordings of trainees performing a colonoscopy procedure. TA audio was transcribed verbatim and content was analyzed to determine valence of verbalizations, frequency of verbalized themes, and level of verbalizations in relation to depth of response.

Results: Descriptive differences were observed between trainers, highlighting a lack of consistency in relation to their thoughts while observing a trainee perform colonoscopy.

Conclusions: This study provides support for use of TA as a method to understand trainer cognition in colonoscopy. It suggests the need for further research to explore consistency of training across trainers.