RESULTS: Age, postgraduate year, and prior endoscopy and ERCP experience positively correlate with skill level (all p 1,000 colonoscopies performed before). Data are given as medians and analyzed using proper nonparametric tests. MENTOR SIZER SIMILAR PLUSBy online survey, subjects assessed the graphics, procedural accuracy, difficulty, and haptics, plus overall realism and training potential of the simulator using Likert-type scales. Performance measures include times to complete procedure, reach papilla, and apply flouroscopy number of attempts to cannulate the papilla, pancreatic duct, and common bile duct number of contrast injections use of endoscopic tools, and complications. Case 2 involves common bile duct brushing and balloon dilation for stricture plus sphincterotomy and stent placement for duct decompression. Case 1 requires stent placement with optional sphincterotomy for cystic duct leak. After 30 minutes of monitored practice to ensure simulator familiarity, subjects completed two cases. RESULTS: With module 1, only the time taken to reach the cecum was different between the groups: experienced group (1.6 min IQR, 1.2-1.9 min) versus novice group (3.2 min IQR, 2.4-4 min) (p 200 ERCPs) skill levels. A p value less than 0.05 was considered statistically significant. Data are expressed as median and interquartile range (IQR). The data reported by the simulator after each module were compared using the Wilcoxon-Mann-Whitney test. Three virtual colonoscopy simulation modules of increasing difficulty were used (modules I-1, II-2, and I-7). The correlation between scores on the two platforms was 0.86 (0.77:0.91 p 50 scope experiences, n = 8). The mean (95 % confidence interval) FES scores were 72 (67:77) on the GI Mentor™ II and 66 (60:71) on the Express. RESULTS: There were 58 participants (mean age 32 76 % male) with a broad range of endoscopic experience. Scores were calculated using the same standardized computer-generated algorithm and compared using Pearson’s correlation coefficient. Each completed the five FES tasks on both simulator platforms in random order, with 3-14 days between tests. STUDY DESIGN: General surgery residents at various levels of training and practicing endoscopists at five institutions participated. The purpose of this study was to obtain evidence for the validity of scores obtained on the Express platform, so that it can be used for testing. A more compact and lower-cost alternative (GI Mentor™ Express) was developed to address this issue. A potential limitation of the FES™ skills test is the size and cost of the simulator on which it was developed (GI Mentor™ II virtual reality endoscopy simulator Simbionix LTD, Israel). īACKGROUND: The fundamentals of endoscopic surgery (FES) examination measures the knowledge and skills required to perform safe flexible endoscopy. Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montreal, QC, Canada Mueller CL1, Kaneva P, Fried GM, Mellinger JD, Marks JM, Dunkin BJ, van Sickle K, Vassiliou MC. Validity evidence for a new portable, lower-cost platform for the fundamentals of endoscopic surgery skills test. Additionally, new training needs and new emerging technologies are discussed to understand where medical education is heading. This review offers a broad view of the technology available for GI endoscopy training, including platforms currently in the market and the relevant advancements in this research and application field. This is particularly true nowadays, when the current demographic trend and the most recent pandemic demand, more than ever, the ability to cope with many patients. Considering the recent advancement of technologies (e.g., artificial intelligence, augmented reality, robotics), simulation platforms can now reach high levels of realism, representing a valid and smart alternative to standard trainee/mentor learning programs. From the first endoscopy mannequin, developed in 1969, several simulation platforms have been developed, ranging from purely mechanical systems to more complex mechatronic devices and animal-based models. GI endoscopy simulators represent a valid solution to allow doctors to practice in a pre-clinical scenario. However, conventional endoscopic techniques are technically demanding and require visual-spatial skills and significant hands-on experience. Gastrointestinal (GI) endoscopy is the gold standard in the detection and treatment of early and advanced GI cancers. Martina Finocchiaro, Pablo Cortegoso Valdivia, Albert Hernansanz, Nicola Marino, Denise Amram, Alicia Casals, Arianna Menciassi, Wojciech Marlicz, Gastone Ciuti and Anastasios Koulaouzidis. Training Simulators for Gastrointestinal Endoscopy: Current and Future Perspectives
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