Establishment and Efficacy of an Endoscopic Pathogen Visualization Literacy (EPVL) Training Program for Gastroenterologists Based on Fluorescence Rapid On-Site Evaluation (ROSE) Technology

Key Takeaways for GI Nurses

• A structured, 16-hour Endoscopic Pathogen Visualization Literacy (EPVL) training program significantly improved gastroenterologists' ability to interpret fluorescence Rapid On-Site Evaluation (ROSE) images compared to brief traditional teaching (3.5 hours), suggesting that comprehensive, hands-on training models are more effective for building competency in emerging endoscopic imaging technologies.
• Fluorescence ROSE technology is gaining traction as a real-time pathogen visualization tool during endoscopy, and GI nurses working in procedure rooms should anticipate increased use of this technology, along with the associated need for staff training on new equipment, workflows, and real-time specimen handling.
• Image interpretation accuracy improved substantially in the trained group (from 57.8% to 82.5%), reinforcing that structured education—not just passive exposure—is essential for accurate, confident use of visualization-based diagnostic tools by the entire endoscopy team, including nursing staff who assist with image acquisition and documentation.
• As fluorescence ROSE and similar point-of-care pathogen detection technologies become more integrated into endoscopic practice, GI nurses will play a key role in specimen preparation, quality control, and communication of real-time findings to the care team, making foundational literacy in these systems increasingly relevant to nursing competency development.

Clinical Relevance

This study highlights an important shift in endoscopic practice toward real-time pathogen visualization using fluorescence ROSE technology, a tool that allows immediate on-site assessment of biological specimens during endoscopic procedures. For GI nurses, this trend has direct implications for procedural workflow. As physicians adopt this technology to make faster, more informed decisions during the procedure—such as determining specimen adequacy or identifying pathogens in real time—nursing staff will increasingly be called upon to support specimen collection, ensure appropriate handling protocols, and assist in coordinating rapid communication between the endoscopy suite and pathology or microbiology teams.

The finding that structured, comprehensive training (16 hours) produced significantly greater improvement in image interpretation accuracy than brief traditional instruction (3.5 hours) is a valuable reminder that competency with new diagnostic technologies cannot be assumed after minimal orientation. This has direct relevance for nursing education and continuing professional development. Endoscopy units introducing fluorescence ROSE or similar visualization tools should consider structured, multi-component training curricula—rather than brief in-services—for all team members, including nurses, to ensure consistent understanding of image interpretation, workflow integration, and clinical decision support.

From an operational standpoint, as pathogen visualization tools become more standardized in endoscopic practice, nurses may increasingly serve as key liaisons in quality assurance, ensuring that image acquisition and specimen processing meet the standards required for accurate interpretation. Understanding the basics of EPVL concepts, even if nurses are not the primary interpreters of ROSE images, supports better interdisciplinary communication, enhances patient safety during real-time decision-making, and prepares nursing staff to contribute meaningfully to competency assessments and training initiatives within their units.

Bottom Line

As fluorescence ROSE technology becomes more integrated into endoscopic pathogen detection, GI nurses should recognize that effective use of this tool requires structured, comprehensive training—not brief orientation—and should advocate for similar in-depth educational approaches within their own units to support safe, accurate, and efficient real-time diagnostic workflows.