Purpose: A program to train registered nurses to perform flexible sigmoidoscopy (FS) has been developed in Ontario, Canada to create increased endoscopy capacity to screen for colorectal cancer. The nurses initially undertook simulator training and they have begun performing procedures on patients. This represents a new role for nurses in Ontario. Objectives: To develop standardized evaluation tools to monitor nurses' performance of FS on patients. Methods: Evaluation of performance on patients was conducted by checklists and global assessments completed by expert observers and by patients completing a patient satisfaction survey. We modified the Patient Satisfaction Questionnaire III (PSQ-III) to include five domains: interpersonal aspects, communication, technical quality, time spent with provider, and general satisfaction. Results: Five nurse trainees have performed at least ten procedures each. Figure 1 shows the general satisfaction scores of patients seen by two different trainees. It demonstrates that with increasing experience, an improving profile is seen for one trainee (Figure 1a) but a deteriorating profile is seen for another (Figure 1b). These trends are supported by the evaluations obtained by checklists and global assessments. (Data not shown.)FigureConclusions: These preliminary data show that the general satisfaction of patients improves with increasing skill of the nurse trainee and they may help differentiate between endoscopists with good skill level and those with poor skill level. The trainees continue to see patients and further data will be collected and evaluated. [figure 1][figure 2]Figure