"Into the fire" approach to teaching endoscopic foreign body removal using a modular simulation curriculum

Area of Science:

• Medical Education
• Surgical Training
• Minimally Invasive Surgery

Background:

• Flexible endoscopy is a crucial minimally invasive surgical technique.
• A need exists for efficient training in therapeutic endoscopy, particularly foreign body removal.
• This study developed a modular, simulation-based curriculum for endoscopic foreign body removal.

Purpose of the Study:

• To evaluate the effectiveness of a novel simulation-based curriculum for training physicians in endoscopic foreign body removal.
• To assess improvements in knowledge, technical skills, and confidence among participants.
• To validate the

Main Methods:

• Two advanced flexible endoscopy course sessions were conducted using ex-vivo porcine models.
• The curriculum incorporated hands-on simulation, didactics, and mentored practice.
• Pre- and post-course assessments (written exams, skills tests, surveys) were analyzed using the Wilcoxon-signed rank test.

Main Results:

• Knowledge scores significantly improved from 3.4 to 5.8 (p < 0.001).
• Technical facility scores increased significantly from 15.8 to 23.6 (p < 0.001), with improvements in instrument use, manipulation, and removal.
• Participant confidence significantly increased from 11.6 to 23.0 (p < 0.001).

Conclusions:

• The simulation-based "into the fire" curriculum is effective for improving endoscopic foreign body removal skills.
• Hands-on simulation-based pre-testing enhances training efficiency by tailoring to individual provider experience.
• The curriculum successfully boosts knowledge, confidence, and technical performance in therapeutic endoscopy.