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The purpose of this paper is to explore doctors' experiences with participation in a quality assurance programme for gastrointestinal endoscopy (Gastronet).

An explorative and qualitative approach was used, and data were generated through semi‐structured interviews with eight doctors (endoscopists) in Norway.

The respondents' notion of a “high‐quality colonoscopy” included being able to communicate with the patient while performing the technical procedure. They were reluctant to use analgesics to improve their score on the rate of painful examinations due to the negative effects of analgesics on the communication with the patient. The individual feedback reports on colonoscopy quality had been read by most respondents and some respondents described they had used the reports actively to monitor performance. There was some reluctance towards the programme among the respondents since some performance measures were thought to have a negative effect on the atmosphere in the endoscopy suite.

The small sample size and the homogenous cultural setting limit the generalisability of the results to other countries.

The concept of “high‐quality colonoscopy” might be ambiguous, and it is important to clarify what quality means when implementing a quality assurance programme for gastrointestinal endoscopy. Workshops and educational meetings facilitate two‐way communication between leaders and participants in the quality assurance programme, and may build ownership and increase motivation among participants.

In addition to quality indicators, it is important to agree upon the meaning of “quality” when initiating a quality assurance programme.