Validation and efficacy of the Varix Trainer model as a Training device for esophagogastroduodenoscopy

Background and study aims The Varix Trainer model 1 (VTM1) was created for trainees to safely practice basic endoscope manipulation skills. The VTM1 was tested to see if it could distinguish levels of endoscope manipulation skills (construct validity) and whether training with it could improve these skills faster (content validity). Patients and methods We enrolled 23 novice endoscopists, 18 second-year trainees, and 13 expert endoscopists. They were asked to point with the endoscope tip to 20 numbers in the model as quickly as possible using torque, single-hand small/large wheel manipulation (SHSW), and retroflexion techniques. Their mean times (t20) were compared to determine if the model could distinguish different levels of expertise. Subsequently, 14 novices trained for eight short sessions, and the pre-training and post-training t20 were compared. Nine novice endoscopists received no training and were retested after 4 to 6 weeks (controls). Results Experts had faster t20 than second-year trainees, who were faster than novices, for all three techniques ( P < 0.001). After eight sessions, the mean t20 for novices improved from 112 to 66 seconds for torque, 144 to 72 seconds for SHSW, and 108 to 63 seconds for retroflexion, (all P < 0.001). Their t20 were equivalent to second-year trainees. Improvement in t20 was also seen with the control group, but total reduction was less than for the training group. Conclusions The VTM1 distinguished varying levels of expertise for all techniques, suggesting that it is a valid tool for assessing endoscope manipulation skill. A short curriculum improved novices' manipulation skills faster than traditional practice.