Introduction: Colorectal cancer (CRC) is a leading cause of cancer-related death, yet only ∼65% of age-eligible adults receive appropriate screening. In a resident-led primary care clinic, lack of provider recommendation presents a barrier to screening. This quality improvement project aimed to improve resident confidence in recommending various CRC screening modalities and increase the number of age-appropriate screening referrals made. Methods: A CRC educational module and decision algorithm were designed and presented to internal medicine residents at a single primary care clinic. Each resident was provided a list of patients due for CRC screening. Resident knowledge of and confidence in recommending various CRC screening modalities were assessed on a 5-point Likert scale and with questionnaires via pre- and post-intervention surveys. CRC screening referral rates from 30 months before and 6 months after the intervention were evaluated. Statistical process control (SPC) charts were created to determine if CRC screening referrals significantly increased following the intervention. Results: Of the 60 residents, 59 participated in the pre-survey and 41 in the post-survey. After the educational intervention, residents reported significantly increased confidence in obtaining a list of patients on their panel not up to date on screening (P < 0.05), identifying screening options available at their practice (P < 0.001), and discussing options for CRC screening with patients (P < 0.05). Confidence in recommending guideline-based screening, follow-up, and assisting patients in overcoming barriers for Cologuard (P < 0.001) and FOBT (P < 0.05) also increased. Residents identified inadequate provider training, lower prioritization, and financial limitations as major barriers to successful screening. There was a significant increase in Cologuard referrals and decrease in FOBT (P < 0.01), but there was no significant change in total CRC screening or colonoscopy referrals after the intervention. Conclusion: This study demonstrates that a resident-led curriculum on CRC screening can improve provider confidence in counseling patients on CRC screening modalities and follow-up. Our intervention resulted in a statistically significant increase in referral rates for Cologuard, but did not show an increase in the number of total CRC screening or colonoscopy referrals. Ongoing data collection will evaluate for trends that may suggest a delayed improvement in CRC screening referrals with additional educational interventions.Figure 1.: Monthly CRC Screening Referrals by Modality Legend: Screening Method Blue - Colonoscopy Orange - Cologuard Yellow - Fecal Occult Blood Test Dashed - Intervention Start DateTable 1.: Pre- and Post-Intervention Survey Responses *Significance calculated using the Mann-Whitney U test