User, expert, and construct validation of a new colonoscopy simulator: correlation with National Endoscopy Database...

Area of Science:

• Medical Simulation
• Gastrointestinal Endoscopy Training
• Surgical Skills Assessment

Background:

• Flexible gastrointestinal endoscopy training faces challenges with current simulation tools lacking real-time feedback and alignment with key performance indicators (KPIs).
• The Mikoto colonoscopy simulator offers real-time feedback and a performance score (Mikoto Simulator Score [MSS]) to address these limitations.

Purpose of the Study:

• To establish construct and user validation for the Mikoto Simulator Score (MSS).
• To assess the alignment of the Mikoto simulator's performance metrics with endoscopists' established KPIs and user feedback.

Main Methods:

• Twenty endoscopists across novice, training, competent, and expert levels performed three colonoscopies on the Mikoto simulator.
• Participants' United Kingdom National Endoscopy Database (NED) KPIs were recorded, and simulator performance (cecal intubation time, MSS) was measured.
• User validity was assessed through a structured questionnaire on utility and realism.

Main Results:

• Significant differences in NED KPIs and MSS were observed across experience levels (P = .046).
• A linear correlation was found between lifetime colonoscopy numbers and MSS (P = .027).
• MSS strongly correlated with NED colonoscopy comfort score (P < .001), polyp detection rate (P < .001), and cecal intubation rate (P < .001).

Conclusions:

• The Mikoto simulator aligns with NED KPIs for colonoscopy, validating its use as an indicator of endoscopic competence in a simulated setting.
• The simulator shows potential for enhancing endoscopic training and improving patient outcomes.
• Further research is recommended to integrate the Mikoto simulator into formal endoscopy training programs.