Acquiring basic endoscopy skills by training on the GI Mentor II

Abstract

Background: Achieving proficiency in flexible endoscopy requires a great amount of practice. Virtual reality (VR) simulators could provide an effective alternative for clinical training. This study aimed to gain insight into the proficiency curve for basic endoscope navigation skills with training on the GI Mentor II. Methods: For this study, 30 novice endoscopists performed four preset training sessions. In each session, they performed one EndoBubble task and managed multiple VR colonoscopy cases (two in first session and three in subsequent sessions). Virtual reality colonoscopy I-3 was repeatedly performed as the last VR colonoscopy in each session. The assignment for the VR colonoscopies was to visualize the cecum as quickly as possible without causing patient discomfort. Five expert endoscopists also performed the training sessions. Additionally, the performance of the novices was compared with the performance of 20 experienced and 40 expert endoscopists. Results: The novices progressed significantly, particularly in the time required to accomplish the tasks (p < 0.05, FriedmanÕs analysis of variance [ANOVA], p < 0.05, Wilcoxon signed ranks). The experts did not improve significantly, except in the percentage of time the patient was in excessive pain. For all the runs, the performance of the novices differed significantly from that of both the experienced and the expert endoscopists (p < 0.05, Mann-Whitney U). The performance of the novices in the latter runs differed less from those of both the experienced and the expert endoscopists. Conclusions: The study findings demonstrate that training in both VR colonoscopy and EndoBubble tasks on the GI Mentor II improves the basic endoscope navigation skills of novice endoscopists significantly.

Training and competence assessment in GI endoscopy: a systematic review

“…Several studies on simulator learning curves for EGD, sigmoidoscopy and colonoscopy had a moderate level of quality 31 32 34 36 38–41 43–45 47 49–52. Nonetheless, some studies only measured performance during VR endoscopy, which is obviously inferior to measuring performance during patient-based endoscopy, since the ultimate goal is improvement of patient-based performance 33 35 36 38 44 45 47 51. Based on this evidence, one can conclude that simulator training is complementary to patient-based learning and is useful in the early training phase in speeding up the early learning curve and reducing patient burden.…”

Training in endoscopic mucosal resection and endoscopic submucosal dissection: Face, content and expert validity of the live porcine model

“…This questionnaire is based on similar validation questionnaires from previous studies from our group. 20,21 The first part is related to demographic data and includes level and range of endoscopic and simulators experience. The second part is centred on the realism of the animal model, namely in accomplishing multiband EMR, ESD and dealing with complications, compared to human setting.…”

The emerging role of screen based simulators in the training and assessment of colonoscopists

“…A significant improvement in novices' performance was seen over time on both the EndoBubble exercise and simulated colonoscopy cases on the GI Mentor II. Experts, however, showed limited improvement on the same exercises 11. After a period of training on the simulator, novices matched the performance metrics achieved by the experts when tested on a previously unseen colonoscopy case 10.…”

“…Overall, experts performed significantly better on the EndoBubble and EndoBasket tasks than novices 10 11. When performance on simulated colonoscopy cases was assessed, the expert groups were again significantly better than novices, procedure time and mucosal visualisation once more appearing the most reliable parameters.…”