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Training with a computer-based simulator achieves basic manual skills required for upper endoscopy: a randomized controlled trial.

Emilio Di Giulio·Diego Fregonese·Tino Casetti·Renzo Cestari·Fausto Chilovi·Giancarlo D'Ambra·Giovanni Di Matteo·Leonardo Ficano·Gianfranco Delle Fave
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Abstract

BACKGROUND: Changes in medical practice have constrained the time available for education and the availability of patients for training. Computer-based simulators have been devised that can be used to achieve manual skills without patient contact. This study prospectively compared, in a clinical setting, the efficacy of a computer-based simulator for training in upper endoscopy. METHODS: Twenty-two fellows with no experience in endoscopy were randomly assigned to two groups: one group underwent 10 hours of preclinical training with a computer-based simulator, and the other did not. Each trainee performed upper endoscopy in 19 or 20 patients. Performance parameters evaluated included the following: esophageal intubation, procedure duration and completeness, and request for assistance. The performance of the trainees also was evaluated by the endoscopy instructor. RESULTS: A total of 420 upper endoscopies were performed; the computer pretrained group performed 212 and the non-pretrained group, 208. The pretrained group performed more complete procedures (87.8% vs. 70.0%; p < 0.0001), required less assistance (41.3% vs. 97.9%; p < 0.0001), and the instructor assessed performance as "positive" more often for this group (86.8% vs. 56.7%; p < 0.0001). The length of procedures was comparable for the two groups. CONCLUSIONS: The computer-based simulator is effective in providing novice trainees with the skills needed for identification of anatomical landmarks and basic endoscopic maneuvers, and in reducing the need for assistance by instructors.

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AdultClinical CompetenceComputer SimulationEndoscopy, GastrointestinalEsophagusFemaleGastroenterologyHumansIntubationMaleMiddle AgedClinical TrialJournal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov't

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Emilio Di Giulio, Diego Fregonese, Tino Casetti, Renzo Cestari, Fausto Chilovi, Giancarlo D'Ambra, Giovanni Di Matteo, Leonardo Ficano, Gianfranco Delle Fave. 2004. Training with a computer-based simulator achieves basic manual skills required for upper endoscopy: a randomized controlled trial.. https://doi.org/10.1016/s0016-5107(04)01566-4

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