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GE-Portuguese Journal of Gastroenterology
Print version ISSN 2341-4545
Abstract
MORATO, Rita; TOME, Luís; DINIS-RIBEIRO, Mário and ROLANDA, Carla. Endoscopic Skills Training: The Impact of Virtual Exercises on Simulated Colonoscopy. GE Port J Gastroenterol [online]. 2022, vol.29, n.6, pp.4-14. Epub Jan 02, 2023. ISSN 2341-4545. https://doi.org/10.1159/000520237.
Background:
A previous study suggested that psychomotor training improves the performance on colonoscopy. Since then, newer exercises have been included in the latest generation of GI Mentor®. In order to optimize a colonoscopy training program, we aimed to determine the impact of 3 virtual exercises in simulated colonoscopy skills.
Methods:
This was a prospective and randomized study. Nineteen residents completed a pre-training questionnaire and a colonoscopy trial before randomization in a study group (n = 10) that performed three exercises (Endobubble I, Navigation I, and Mucosal Evaluation I) until they achieved expert level, and a control group (n = 9). Both groups performed 10 repetitions of a simulated colonoscopy and were assessed on a final case. Learning curves and skills transfer were assessed by four parameters: mucosal surface examined (%), time to reach the cecum (s), screening efficiency (%), and time the patient was in pain (%). We also evaluated the construct validity for the exercises.
Results:
Construct validity was confirmed for Endobubble I and verified in Navigation I (experts were faster than novices; 5 vs. 7 s, p = 0.040), but not for Mucosal Evaluation I. Analyzing the learning curves and performance in the 10 repetitions, the study group reached the cecum faster (278 vs. 356 s, p = 0.035) and achieved a higher screening efficiency (83% vs. 75%, p = 0.019). Concerning skills transfer, the control group took longer to reach the cecum (241 vs. 292 s, p = 0.021) and the percentage of time the patient was in pain was higher (6% vs. 9%, p = 0.021). General performances of the study group had smaller interquartile variations.
Conclusion:
Psychomotor training has a significant impact on the homogeneous acquisition and assimilation of colonoscopy skills. Endobubble I and Navigation I should be considered in the training programs for novices.
Keywords : Colonoscopy; Psychomotor skills; Training; Competency; Medical education.