Development and validation of a simulation-based assessment tool in colonoscopy.

Area of Science:

• Medical Education
• Gastroenterology
• Simulation Technology

Background:

• Colonoscopy skills are challenging to acquire.
• Virtual reality (VR) simulation aids training, but progression to patient-based learning requires defined assessment.
• No standardized tool exists for credentialing novice endoscopists.

Purpose of the Study:

• To develop a VR-based assessment tool for colonoscopy.
• To ensure the tool discriminates between skill levels (novice, intermediate, expert).
• To incorporate essential patient safety checklist items.

Main Methods:

• Validation followed Standards for Educational and Psychological Testing.
• Expert panel identified three critical patient safety items (perforation, bowel wall tension, cecal intubation).
• Simbionix GI Mentor II simulator metrics were analyzed for discriminatory ability and combined into an aggregate score.

Main Results:

• Four metrics with discriminatory ability were identified.
• Aggregate scores differed significantly between novices and other groups (p<0.01).
• The tool demonstrated good reliability (Cronbach's alpha=0.86) with a defined pass/fail standard.

Conclusions:

• A valid and reliable VR assessment tool with a pass/fail standard was established.
• The tool can assess competency after simulation-based training.
• It is recommended before commencing patient-based learning.