Randomized prospective multi-site validation study.

GI practice sites that have recently agreed to participate in the GIQuIC program will be randomized on a site-basis, to the EQUIP intervention or control.

Baseline ADR and polyp/surveillance predication accuracy will be collected for approximately 3 months.

Sites randomized to the EQUIP intervention will undergo face-to-face training by a study investigator, followed by active monitoring and feedback.

Control sites will not receive supplemental training and will be monitored by with no feedback. After completion of the study all sites will be offered the intervention (as is standard feedback in GIQuIC ).

Inclusion Criteria:

• Endoscopy centers that are new to GIQuIC and have not yet received training
• All endoscopists performing screening and surveillance colonoscopy at the participating center will be invited to participate

Exclusion Criteria:

• Cases that involve acute indications such as bleeding and active colitis will not be included in data pool
• Patients with a family or personal history of a polyposis syndrome or with a personal history of inflammatory bowel disease will also be excluded
• Procedures that are deemed incomplete will be excluded
• Patients with surgically altered anatomy (i.e. prior colectomy) and with poor bowel preparation (Boston bowel preparation score <5, or inadequate to exclude polyps >5mm) will be excluded