What is it about?
In this technological era, endoscopic simulation has also rapidly evolved to facilitate training in a controlled environment. Although there is sufficient evidence for its use, there is no optimal method for its integration in the training programs. Existing studies have exposed trainees to a diversity of experiences and tasks/exercises, one of those suggested that hand-eye coordination or virtual psychomotor exercises improve the performance on colonoscopy cases. In order to optimize our colonoscopy training program, we designed a prospective study to determine the impact of 3 virtual exercises (Endobubble I, Navigation I, and Mucosal Evaluation I) - to address endoscopic navigation and mucosal evaluation, in simulated colonoscopy skills.
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Why is it important?
Construct validity was confirmed for Endobubble I (previously evaluated) and verified in Navigation I (new information), but not for Mucosal Evaluation I. When analyzing the learning curves and performance, the Study Group reached the cecum faster and achieved a higher screening efficiency. Concerning skills transfer to a new colonoscopy exercise, the Control Group took longer to reach the cecum and induced more pain to the simulated patient. Thus the psychomotor training (with two of exercises) had a significant impact on the homogeneous acquisition and assimilation of colonoscopy skills by the Study Group, and should be included in the training alongside colonoscopy cases.
Perspectives
We believe that Endobubble I and Navigation I work on the same skills to potentiate dexterity benefits and improve training for novices. Mucosal Evaluation is not a true “psychomotor” exercise, and probably it can be trained directly in the colonoscopy module. A useful addition of our study is the definition of an expert level in those exercises, in a training program it is probably better than having a predefined number of repetitions, because this accommodates the natural skills and specific needs of each resident. Based on these results we advanced in a subsequent study: Mendes S, Areia M, Dinis-Ribeiro M, Rolanda C. The impact of a structured virtual reality simulation training curriculum for novice endoscopists. GE Port J Gastroenterol. 2021. DOI: 10.1159/000519927.
Carla Rolanda
Read the Original
This page is a summary of: Endoscopic Skills Training: The Impact of Virtual Exercises on Simulated Colonoscopy, GE - Portuguese Journal of Gastroenterology, April 2022, Karger Publishers,
DOI: 10.1159/000520237.
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