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Simulated colonoscopy training leads to improved performance during patient-based assessment - 23/02/15

Doi : 10.1016/j.gie.2014.09.014 
Arjun D. Koch, MD, PhD 1, , Vivian E. Ekkelenkamp, MD 1, Jelle Haringsma, MD 1, Erik J. Schoon, MD, PhD 2, Robert A. de Man, MD, PhD 1, Ernst J. Kuipers, MD, PhD 1
1 Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands 
2 Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, the Netherlands 

Reprint requests: Arjun D. Koch, MD, PhD, Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Room Hs-310, PO Box 2040, 3000 CA Rotterdam, the Netherlands.

Abstract

Background

Virtual reality (VR) endoscopy simulators are increasingly being used in the training of novice endoscopists. There are, however, insufficient data regarding the effect of simulator training on the early learning curve of novice endoscopists.

Objective

The aim of this study was to assess the clinical performance of novice endoscopists during colonoscopy after intensive and prolonged training on a VR endoscopy simulator.

Design

Prospective study.

Setting

Single university medical center.

Patients

Patient-based assessment (PBA) of performance was carried out on patients routinely scheduled for colonoscopy.

Interventions

Eighteen trainees without any endoscopic experience were included in the study. They were divided into 2 groups. The simulator-training program consisted of either 50 (group I) or 100 (group II) VR colonoscopies. After 10, 30, and 50 (group I) and after 20, 60, and 100 (group II) VR colonoscopies, trainees underwent both simulator-based assessment and PBA.

Main Outcome Measurements

Cecal intubation time, colonic insertion depth, and cecal intubation rate.

Results

Eighteen novices participated in the study. All completed VR training and assessments. The mean cecal intubation time on the SBA decreased from a baseline of 9.50 minutes to 2.20 minutes at completion of the training (P = .002). Colonic insertion depth during PBA improved from 29.4 cm to 63.7 cm (P < .001). The learning effect of simulator training ceased after 60 colonoscopies.

Limitations

Single-center study, no formal sample size calculation.

Conclusions

VR training by using a colonoscopy simulator leads to a significant improvement in performance with the simulator itself and, more importantly, to significantly improved performances during patient-based colonoscopy. This study demonstrates the rationale for intensive simulator training in the early learning curve of novices performing colonoscopy.

Il testo completo di questo articolo è disponibile in PDF.

Abbreviations : PBA, VR


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 DISCLOSURE: All authors disclosed no financial relationships relevant to this article.
 If you would like to chat with an author of this article, you may contact Dr Koch at a.d.koch@erasmusmc.nl.


© 2015  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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