A Pilot Randomized Cross-Over Trial Focused on Colonoscopy Skill Acquisition Using High Fidelity Versus Low Fidelity...

Area of Science:

• Medical Education
• Gastroenterology
• Surgical Training

Background:

• Colorectal cancer (CRC) presents a growing global health challenge, particularly in low- and middle-income countries (LMICs).
• Enhancing colonoscopy expertise through training is vital to combatting rising CRC incidence and mortality.
• Simulation-based training offers a controlled environment for developing colonoscopy skills.

Purpose of the Study:

• To evaluate the efficacy of low-fidelity (LF) colonoscopy simulation models compared to high-fidelity (HF) models for skill acquisition and confidence.
• To assess the feasibility of using locally developed LF models in resource-constrained environments.

Main Methods:

• A randomized crossover trial involving surgeons, residents, and gastroenterologists in Nigeria.
• Training incorporated a 9-week online lecture series and a 4-day in-person workshop using both HF and LF simulators.
• Performance was measured using the Mayo Colonoscopy Skills Assessment Tool (MCSAT) and Global Assessment of Gastrointestinal Endoscopic Skills (GAGES).

Main Results:

• Both LF and HF simulation groups showed significant improvements in median MCSAT and GAGES scores over time.
• Statistically significant differences favoring simulation training were noted in specific GAGES sub-scores after initial training.
• No significant differences in final exam scores between HF and LF groups indicated skill convergence by the end of the course.
• Participants in both groups reported significant increases in confidence.

Conclusions:

• Low-fidelity colonoscopy simulation models facilitate comparable skill acquisition and confidence enhancement to high-fidelity models.
• LF models represent a cost-effective and viable educational tool for colonoscopy training in LMICs.
• This approach can help expand the colonoscopy workforce to address the global burden of colorectal cancer.