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Gastrointest Endosc. 2010 Feb;71(2):298-307. doi: 10.1016/j.gie.2009.07.017. Epub 2009 Nov 3.

Training and transfer of colonoscopy skills: a multinational, randomized, blinded, controlled trial of simulator versus bedside training.

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  • 1Wolfson Unit for Endoscopy, St. Mark's Hospital, Imperial College London, London, UK. ahaycock@imperial.ac.uk.

Abstract

BACKGROUND:

The Olympus colonoscopy simulator provides a high-fidelity training platform designed to develop knowledge and skills in colonoscopy. It has the potential to shorten the learning process to competency.

OBJECTIVE:

To investigate the efficacy of the simulator in training novices in colonoscopy by comparing training outcomes from simulator training with those of standard patient-based training.

DESIGN:

Multinational, multicenter, single-blind, randomized, controlled trial.

SETTING:

Four academic endoscopy centers in the United Kingdom, Italy, and The Netherlands.

PARTICIPANTS AND INTERVENTION:

This study included 36 novice colonoscopists who were randomized to 16 hours of simulator training (subjects) or patient-based training (controls). Participants completed 3 simulator cases before and after training. Three live cases were assessed after training by blinded experts.

MAIN OUTCOME MEASUREMENTS:

Automatically recorded performance metrics for the simulator cases and blinded expert assessment of live cases using Direct Observation of Procedural Skills and Global Score sheets.

RESULTS:

Simulator training significantly improved performance on simulated cases compared with patient-based training. Subjects had higher completion rates (P=.001) and shorter completion times (P < .001) and demonstrated superior technical skill (reduced simulated pain scores, correct use of abdominal pressure, and loop management). On live colonoscopy, there were no significant differences between the 2 groups.

LIMITATIONS:

Assessment tools for live colonoscopies may lack sensitivity to discriminate between the skills of relative novices.

CONCLUSION:

Performance of novices trained on the colonoscopy simulator matched the performance of those with standard patient-based colonoscopy training, and novices in the simulator group demonstrated superior technical skills on simulated cases. The simulator should be considered as a tool for developing knowledge and skills prior to clinical practice.

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PMID:
19889408
[PubMed - indexed for MEDLINE]
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