Adaptation of the fundamentals of laparoscopic surgery box for endoscopic simulation: performance evaluation of the first 100 participants

BackgroundThe paucity of readily accessible, cost-effective models for the simulation, practice, and evaluation of endoscopic skills present an ongoing barrier for resident training. We have previously described a system for conversion of the Fundamentals of Laparoscopic Surgery box (FLS) for flexible endoscopic simulation. Six endoscopic tasks focusing on scope manipulation, and other clinically relevant endoscopic skills are performed within a 5-min time limit per task. This study describes our experience and validation results with the first 100 participants.MethodsA total of 100 participants were evaluated on the simulator. Thirty individuals were classified as experts (having done over 200 endoscopic procedures), and 70 were classified as trainees (39 individuals reported having no prior endoscopy experience). Of the 100 participants, 55 individuals were retested on the simulator within a period of 4 months. These 55 individuals were also evaluated using the “Global Assessment of Gastrointestinal Endoscopic Skills” (GAGES). T-tests and Pearson correlations were used where appropriate, values less than 0.05 were considered significant.ResultsExperts completed all six tasks significantly faster than trainees. For the 55 participants who were retested on the simulator, all tasks demonstrated evidence of test–retest reliability for both experts and trainees who did not practice in between tests. Moderate correlations between lower completion times and higher GAGES scores were observed for all tasks except the clipping task.ConclusionsThe results from the first 100 participants provide evidence for the simulator’s validity. Based on task completion times, we found that experts perform significantly better than trainees. Additionally, preliminary data demonstrate evidence of test–retest reliability, as well as GAGES score correlation. Additional studies to determine and validate a scoring system for this simulator are ongoing.Graphical abstract

[1]  Benjamin K. Poulose,et al.  Global Assessment of Gastrointestinal Endoscopic Skills (GAGES): a valid measurement tool for technical skills in flexible endoscopy , 2010, Surgical Endoscopy.

[2]  J. Griswold,et al.  Future directions in training surgical residents to perform endoscopic examinations , 2008, The American surgeon.

[3]  Christopher C. Thompson,et al.  Preclinical endoscopic training using a part-task simulator: learning curve assessment and determination of threshold score for advancement to clinical endoscopy , 2017, Surgical Endoscopy.

[4]  L. Swanstrom,et al.  Feasibility of adapting the fundamentals of laparoscopic surgery trainer box to endoscopic skills training tool , 2018, Surgical Endoscopy.

[5]  Pichamol Jirapinyo,et al.  Validation of an endoscopic part-task training box as a skill assessment tool. , 2015, Gastrointestinal endoscopy.

[6]  Sarah B. Placek,et al.  Simulation-based mastery learning for endoscopy using the endoscopy training system: a strategy to improve endoscopic skills and prepare for the fundamentals of endoscopic surgery (FES) manual skills exam , 2017, Surgical Endoscopy.

[7]  S. Trooskin,et al.  Gastrointestinal endoscopy training in general surgery residency: what has changed since 2009? , 2014, Journal of surgical education.

[8]  Ross E. Willis,et al.  A multicenter, simulation-based skills training collaborative using shared GI mentor II systems: results from the Texas association of surgical skills laboratories (TASSL) flexible endoscopy curriculum , 2011, Surgical Endoscopy.

[9]  Yoon Tae Jeen,et al.  An adequate level of training for technical competence in screening and diagnostic colonoscopy: a prospective multicenter evaluation of the learning curve. , 2008, Gastrointestinal endoscopy.

[10]  Roy Phitayakorn,et al.  A proficiency-based virtual reality endoscopy curriculum improves performance on the fundamentals of endoscopic surgery examination , 2018, Surgical Endoscopy.

[11]  G. Fried,et al.  Description and Preliminary Evaluation of a Low-Cost Simulator for Training and Evaluation of Flexible Endoscopic Skills , 2016, Surgical innovation.

[12]  C. Thompson,et al.  Development and initial validation of an endoscopic part-task training box , 2014, Endoscopy.

[13]  Erik J. Schoon,et al.  Expert and construct validity of the Simbionix GI Mentor II endoscopy simulator for colonoscopy , 2007, Surgical Endoscopy.