Simulation Training Improves Trainee Technical Skill and Procedural Attitudes in Endoscopic Gastrostomy Tube...

Area of Science:

• Medical Education
• Gastroenterology
• Surgical Simulation

Background:

• Percutaneous endoscopic gastrostomy (PEG) tube placement is a key gastroenterology fellowship competency.
• Infrequent performance of PEG tube procedures challenges trainee skill development and confidence.
• Existing training may lack sufficient volume for procedural mastery.

Purpose of the Study:

• To evaluate the impact of simulation-based education on trainee technical skill in PEG tube placement.
• To assess changes in procedural attitudes, including self-confidence and perceived skill level, following simulation training.

Main Methods:

• Gastroenterology fellows underwent baseline assessment of technical skill via simulated PEG tube placement and procedural attitudes.
• Individualized simulation training was provided, with repeated practice until >90% checklist proficiency was achieved.
• Technical skill and attitudes were reassessed immediately post-training and at a delayed 6-12 week follow-up.

Main Results:

• Simulation training significantly improved technical skill scores at delayed reassessment (52.9% to 78.0%, P=0.0002).
• Immediate improvements were observed in self-confidence (2.1 to 3.1, P=0.001), perceived skill (2.2 to 4.0, P<0.001), and perceived supervision (2.2 to 3.2, P=0.003).
• These improvements in technical skill and attitudes were sustained at delayed reassessment.

Conclusions:

• Simulation-based educational interventions lead to sustained improvements in technical proficiency and confidence for PEG tube placement.
• Integrating simulation into gastroenterology fellowship curricula is recommended for infrequently performed procedures like PEG tube placement.
• Simulation provides a viable method to enhance competency and confidence in essential endoscopic procedures.