Background and study aims: Prior research supports the validity of
performance measures derived from the use of a physical model colonoscopy
simulator – the Kyoto Kagaku Colonoscope Training Model (Kyoto Kagaku Co.
Ltd., Kyoto, Japan) – for assessing insertion skill. However, its use as a
training tool has received little research attention. We assessed the efficacy
of a brief structured program to develop basic colonoscope insertion skill
through unsupervised practice on the model.
Participants and methods: This was a training study with pretesting and
post-testing. Thirty-two colonoscopy novices completed an 11-hour training
regime in which they practiced cases on the model in a colonoscopy simulation
research laboratory. They also attempted a series of test cases before and after
training. For each outcome measure (completion rates, time to cecum and peak
force applied to the model), we compared trainees’ post-test performance with
the untrained novices and experienced colonoscopists from a
previously-reported validation study.
Results: Compared with untrained novices, trained novices had higher
completion rates and shorter times to cecum overall (Ps < .001), but
were out-performed by the experienced colono-scopists on these metrics
(Ps < .001). Nevertheless, their performance was generally closer
to that of the experienced group. Overall, trained novices did not differ from
either experience-level comparison group in the peak forces they applied
(P > .05). We also present the results broken down by case.
Conclusions: The program can be used to teach trainees basic insertion
skill in a more or less self-directed way. Individuals who have completed the
program (or similar training on the model) are better prepared to progress to
supervised live cases.