Haycock A, Koch AD, Familiari P, van Delft F, Dekker E, Petruzziello L, Haringsma J, Thomas-Gibson S. Training and transfer of colonoscopy skills: a multinational, randomized, blinded, controlled trial of simulator versus bedside training. Gastrointest Endosc. 2010 Feb;71(2):298-307. Epub 2009 Nov 3

PMID: 19889408

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.
 



Author's contacts: ahaycock@imperial.ac.uk