Structured Endoscopy Training and Clinical Competence of Perioperative Nurses in Riyadh: A Sequential Explanatory Mixed-methods Study

Abstract

Aims: This study evaluated changes in colonoscopy-related knowledge and clinical competence among perioperative nurses after a Structured Endoscopy Training Program and explored participants’ explanations of these changes. Study Design: A sequential explanatory mixed-methods study comprising a one-group pretest–posttest quantitative phase and a descriptive qualitative phase. Place and Duration of Study: King Abdulaziz Medical City-Riyadh, Saudi Arabia, during 2026. Methodology: Thirty perioperative nurses completed paired pre-training and post-training assessments of knowledge and five clinical competence domains. Paired differences were analysed using the Wilcoxon signed-rank test. Adult learning experiences were assessed after training. Five participants subsequently completed semi-structured interviews; qualitative data were subjected to thematic analysis and were integrated with quantitative findings through connecting, building, and merging. Results: Knowledge increased from M = 19.77 (SD = 6.89) to M = 22.53 (SD = 7.56), W = 0.00, Z = -4.56, P < .001, r = .88. All five clinical competence domains improved significantly (all P < .001; r = .88-.89) and shifted from Not Competent to Competent. Procedural assistance had the highest post-training mean (M = 4.03, SD = 0.49), whereas equipment troubleshooting had the lowest post-training mean (M = 3.51, SD = 0.77). Five qualitative themes explained improvement through applied understanding, repeated hands-on practice, procedural-flow awareness, differential mastery of familiar versus complex tasks, and clinically relevant experiential learning. Conclusion: Significant within-participant improvements in knowledge and clinical competence were observed following structured endoscopy training. Continued supervised exposure, feedback, mentorship, competency validation, and targeted practice for complex troubleshooting remain important. Because there was no comparison group, causal attribution remains limited.