Telementoring for endoscopic submucosal dissection in vivo training.

Area of Science:

• Gastroenterology
• Surgical Education
• Medical Simulation

Background:

• The COVID-19 pandemic severely disrupted endoscopic training, particularly for complex procedures like endoscopic submucosal dissection (ESD).
• Challenges include the procedure's complexity and a scarcity of local expert trainers.
• There is a need for alternative training models to ensure continued skill development.

Purpose of the Study:

• To design and evaluate a simulation-based endoscopic submucosal dissection (ESD) training course utilizing telementoring and rapid cycle deliberate practice (RCDP).
• To assess the feasibility and effectiveness of remote expert guidance for acquiring complex endoscopic skills.

Main Methods:

• A 2-hour simulation training course on live anesthetized pigs was conducted.
• Participants received a tutorial followed by hands-on practice incorporating RCDP principles.
• Two overseas experts provided real-time telementoring via live video transmission (Zoom) and visual aids.
• External and endoscopic views were shared to facilitate feedback and instruction.

Main Results:

• Eighteen trainees participated, with six receiving telementoring.
• Four ESD procedures were performed under telementoring, achieving 100% en bloc resection without perforation.
• The time required for ESD procedures with telementoring was comparable to on-site mentorship.

Conclusions:

• Telementoring, integrated with RCDP, effectively facilitates knowledge and skill transfer for complex endoscopic procedures like ESD.
• This model provides a viable alternative for remote training, especially when local expertise is limited or international travel is restricted.