Lack of a discriminatory function for endoscopy skills on a computer-based simulator

Area of Science:

• Medical Simulation
• Gastroenterology Training
• Surgical Skills Assessment

Background:

• Computer-based simulators are used for endoscopic skills training.
• Validation of simulators against patient-based endoscopy is lacking.
• Objective assessment of simulator fidelity is crucial for effective training.

Purpose of the Study:

• To validate a computer-based endoscopy simulator against actual procedures.
• To assess the simulator's ability to distinguish between varying levels of endoscopic expertise.
• To evaluate the realism of simulated esophagogastroduodenoscopy (EGD) and colonoscopy.

Main Methods:

• A prospective trial involving gastroenterology fellows and attendings.
• Participants completed simulated EGD and colonoscopy cases on the Simbionix GI Mentor II.
• Objective performance parameters were collected, and participants completed a realism survey.

Main Results:

• No significant overall differences in task completion between novices and experts.
• Simulator discriminated expertise only in time-related parameters (e.g., total time, efficiency).
• Experts found the simulator lacked realistic human endoscopy simulation.

Conclusions:

• The simulator lacks the fidelity to accurately assess endoscopic skills.
• Objective parameters measured by the simulator were insufficient to differentiate expertise.
• Upgrades are needed to enhance the simulator's ability to reproduce human endoscopy accurately.