Simulation-Based Training for Colonoscopy

Abstract

Supplemental Digital Content is available in the text

The efficacy of training insertion skill on a physical model colonoscopy simulator

“…A subsequent study found comparable experienced-novice differences when a magnetic endoscopic imaging device was used in conjunction with custom software to automate measurement of the colonoscope’s progression through the synthetic colon 14. The final study replicated the experienced-novice differences in procedure time, and also demonstrated experience-level effects for a novel suite of observational metrics used in conjunction with the model 15. Such comparisons between user-groups known to have differing levels of experience are a common means of generating evidence for the construct validity of metrics associated with the use of a simulation device; that is, the replication of real-world performance differences implies that the simulation taps into the skill that the metrics purport to measure 23.…”

“…Further, evidence from several recent studies supports the construct validity of several performance measures derived from use of the Kyoto Kagaku model for the assessment of insertion skill 13 14 15. The first of these studies showed that, compared with experienced colonoscopists, novices had lower completion rates, took longer to reach the cecum, and (for 2 of the 4 colon cases tested) exerted more force on the colon model 13, mirroring experience-related differences found in real colonoscopy 16 17 18 19 20 21 22.…”

Systematic review to establish absolute standards for technical performance in surgery

“…For example, Tjiam and colleagues established certification standards for residents in laparoscopic urological skills by comparing global ratings of a cohort of staff surgeons and trainees stratified by case volume into expert, intermediate and novice groups. Seventeen articles used fully qualified surgeons and physicians. Pedersen and co‐workers used expert orthopaedic surgeons as the competent group on a hip fracture simulator, and set standards that trainees must reach before progressing to the clinical environment.…”

“…Fellows are a unique group of participants, as they can be included under the trainee umbrella, and yet are often experienced operators at procedures tested in standard‐setting exercises. In this review, six articles specified the use of fellows as study participants, and two included medical student participants.…”

“…Of the 37 included articles, 24 used participant‐centred methodology to set standards in technical performance. Of these, 18 took place in a simulated setting, and six in a clinical setting ( Table ). The type of assessment tools used in the standard‐setting exercise are shown in Table .…”