Simulator-based training method in gastrointestinal endoscopy training and currently available simulators

Abstract

The apprenticeship-based training method (ABTM) is highly effective for gastrointestinal (GI) endoscopic training. However, the conventional ABTM has significant issues. Although many supplementary training methods (TMs) have been developed and utilized, they cannot entirely replace the ABTM, which remains the major TM strategy. Currently, new TM construction is crucial and necessary due to financial constraints, difficulty of obtaining sufficient training time due to patient safety-related regulations, and catastrophic damage caused by disasters such as the coronavirus disease 2019 pandemic. The simulator-based TM (SBTM) is widely accepted as an alternative to the ABTM, owing to the SBTM's advantages. Since the 1960s, many GI endoscopy training simulators have been developed and numerous studies have been published on their effectiveness. While previous studies have focused on the simulator's validity, this review focused on the accessibility of simulators that were introduced by the end of 2021. Although the current SBTM is effective in GI endoscopic education, extensive improvements are needed to replace the ABTM. Incorporating simulator-incorporated TMs into an improved ABTM is an attempt to overcome the incompleteness of the current SBTM. Until a new simulator is developed to replace the ABTM, it is desirable to operate a simulator-integrated and well-coordinated TM that is suitable for each country and institution.

Impact and assessment of training models in interventional endoscopic ultrasound

“…8,9 Performing IEUS procedures requires high technical skill and expertise. [10][11][12][13] In the absence of widespread training facilities and a high rate of adverse events associated with these procedures, simulation-based training has emerged as a valuable tool for acquiring and maintaining EUS skills, allowing trainees to practice procedures in a safe and controlled environment. 13 To maintain competency, operators must continually update their knowledge and skills through ongoing education and participation in quality assurance programs.…”

“…[10][11][12][13] In the absence of widespread training facilities and a high rate of adverse events associated with these procedures, simulation-based training has emerged as a valuable tool for acquiring and maintaining EUS skills, allowing trainees to practice procedures in a safe and controlled environment. 13 To maintain competency, operators must continually update their knowledge and skills through ongoing education and participation in quality assurance programs. 14 Currently, various training and teaching approaches are used to enhance EUS skills, including digital or computer-assisted simulation models, ex vivo or in vivo models, and phantom simulators.…”

“…Performing IEUS procedures requires high technical skill and expertise 10–13 . In the absence of widespread training facilities and a high rate of adverse events associated with these procedures, simulation‐based training has emerged as a valuable tool for acquiring and maintaining EUS skills, allowing trainees to practice procedures in a safe and controlled environment 13 .…”

EUS and ERCP training in Europe: Time for simulation, optimization, and standardization

“…There are mechanical simulators and computer‐based, virtual reality simulators available. Technically, superior computer‐based simulators such as augmented or mixed reality are still in development and not yet ready for implementation 9 . The duration of the simulation‐based training program and the specific goals to be achieved should be defined in advance.…”

“…In this model, competence is determined based on a number of procedures performed. The limitations of this volume‐based assessment of competence is widely acknowledged and has led to a shift from a volume‐based to an outcomes‐based approach, focusing on predefines competency outcomes 9–11 . Observational assessment tools can be used to evaluate trainee's progression and competence, containing a mix of technical, cognitive and integrative skills, but also pre‐ and post‐procedural, and specific procedure‐related outcomes such as cannulation rate, complication rate, and yield of fine needle aspiration/biopsy (FNA/B).…”