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Updated: Jan 30, 2026

Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists
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Automatic metrics from a new colon phantom can ensure basic competency in colonoscopy.

Anishan Vamadevan1, Linea Mikkeline Lissner2,3, Kristoffer Mazanti Cold2,3

  • 1Center for Human Resources and Education, Copenhagen Academy for Medical Education and Simulation (CAMES), The Capital Region of Denmark, Copenhagen, Denmark. v.anishan@hotmail.com.

Surgical Endoscopy
|January 28, 2026
PubMed
Summary
This summary is machine-generated.

A novel colonoscopy simulator, Mikoto, objectively assesses trainee skill using automated metrics. This tool reliably differentiates competence levels and supports proficiency-based training for colon cancer screening procedures.

Keywords:
ColonoscopyEvidence-based trainingSimulation-based trainingValidity study

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Area of Science:

  • Medical Simulation
  • Gastroenterology
  • Surgical Skills Assessment

Background:

  • Colorectal cancer (CRC) is a leading cause of cancer death globally.
  • Expanding screening necessitates validated tools for colonoscopy competence assessment.
  • This study validates a simulation-based test using a novel colon phantom.

Purpose of the Study:

  • To evaluate the validity evidence of a simulation-based colonoscopy test.
  • To assess the Mikoto simulator's ability to measure colonoscopy competence.
  • To establish objective performance metrics for training and evaluation.

Main Methods:

  • 42 participants (novice, intermediate, experienced) used the Mikoto simulator.
  • Key metrics: time to caecum and Sigmoid-Colon Elongation Index.
  • Mucosal inspection assessed via PolypTumor Detection Score.

Main Results:

  • Simulator metrics reliably distinguished between experience levels (p < 0.001).
  • High reliability for time (Cronbach's α = 0.93) and elongation index (0.83).
  • Novices failed, while 36% of intermediates and 67% of experts passed.

Conclusions:

  • The Mikoto simulator provides objective, reliable, automated assessment of colonoscopy skills.
  • It integrates efficiency and tissue-friendly technique for competence evaluation.
  • Supports proficiency-based training, skills maintenance, and professional re-evaluation.