Development and prospective validation of a scoring system for the Basic Endoscopic Skills Training (BEST) box

Area of Science:

• Medical Education
• Surgical Simulation
• Gastroenterology

Background:

• Endoscopic training demand is rising due to increased use of endoscopy.
• The Basic Endoscopic Skills Training (BEST) box is a low-cost flexible endoscopic simulator.
• Objective performance evaluation is needed for endoscopic training.

Purpose of the Study:

• To develop and validate a scoring system for the BEST box.
• To objectively assess user performance in flexible endoscopic simulation.
• To establish a reliable metric for tracking endoscopic skill progression.

Main Methods:

• Developed a scoring system using linear regression between BEST box performance and Global Assessment of Gastrointestinal Endoscopic Skills-Upper Endoscopy (GAGES-UE).
• Utilized Receiver Operating Characteristic curve analysis to determine performance thresholds.
• Validated the scoring system through retrospective (n=100) and prospective (n=65) analyses, comparing experts and trainees.

Main Results:

• The scoring system effectively differentiated between expert and trainee performance (p < 0.001).
• Scores demonstrated strong correlation with GAGES-UE scores (p < 0.001) and internal reliability (r = 0.765).
• Prospective testing showed significantly higher scores for experts (92) versus trainees (61) (p < 0.001).

Conclusions:

• The BEST box scoring system provides a valid and reliable method for assessing endoscopic skills.
• The system correlates with user experience and established assessment tools like GAGES-UE.
• The BEST box, with its scoring system, serves as an effective, low-cost simulator for tracking endoscopic training progress.