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Expert and construct validity of the Simbionix GI Mentor II endoscopy simulator for colonoscopy.

Koch AD, Buzink SN, Heemskerk J, Botden SM, Veenendaal R, Jakimowicz JJ, Schoon EJ - Surg Endosc (2007)

Bottom Line: The average time to reach the cecum was defined as one of the main test parameters as well as the number of times view of the lumen was lost.Novices lost view of the lumen significantly more often compared to the other groups, and the EndoBubble task was also completed significantly faster with increasing experience (Kruskal Wallis Test, p < 0.001).According to experts the simulator should be implemented in the training programme of novice endoscopists.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands. a.d.koch@erasmusmc.nl

ABSTRACT

Objectives: The main objectives of this study were to establish expert validity (a convincing realistic representation of colonoscopy according to experts) and construct validity (the ability to discriminate between different levels of expertise) of the Simbionix GI Mentor II virtual reality (VR) simulator for colonoscopy tasks, and to assess the didactic value of the simulator, as judged by experts.

Methods: Four groups were selected to perform one hand-eye coordination task (EndoBubble level 1) and two virtual colonoscopy simulations on the simulator; the levels were: novices (no endoscopy experience), intermediate experienced (<200 colonoscopies performed before), experienced (200-1,000 colonoscopies performed before), and experts (>1,000 colonoscopies performed before). All participants filled out a questionnaire about previous experience in flexible endoscopy and appreciation of the realism of the colonoscopy simulations. The average time to reach the cecum was defined as one of the main test parameters as well as the number of times view of the lumen was lost.

Results: Novices (N = 35) reached the cecum in an average time of 29:57 (min:sec), intermediate experienced (N = 15) in 5:45, experienced (N = 20) in 4:19 and experts (N = 35) in 4:56. Novices lost view of the lumen significantly more often compared to the other groups, and the EndoBubble task was also completed significantly faster with increasing experience (Kruskal Wallis Test, p < 0.001). The group of expert endoscopists rated the colonoscopy simulation as 2.95 on a four-point scale for overall realism. Expert opinion was that the GI Mentor II simulator should be included in the training of novice endoscopists (3.51).

Conclusion: In this study we have demonstrated that the GI Mentor II simulator offers a convincing realistic representation of colonoscopy according to experts (expert validity) and that the simulator can discriminate between different levels of expertise (construct validity) in colonoscopy. According to experts the simulator should be implemented in the training programme of novice endoscopists.

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The GI Mentor II virtual reality simulator, the setup for training in lower endoscopy.
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Fig1: The GI Mentor II virtual reality simulator, the setup for training in lower endoscopy.

Mentions: Training skills in endoscopy for diagnostic and therapeutic procedures is essential and requires a great deal of hands-on training [1]. Virtual reality (VR) simulators offer a promising option to train these skills extensively prior to training in real-life colonoscopy, without jeopardizing patients or causing them unnecessary discomfort [2]. The use of VR training prior to performing real flexible endoscopy on patients enables novice endoscopists to go through part of their proficiency curve before submitting patients to their relatively insufficient endoscopy skills. This might not only be advantageous for the patients undergoing endoscopy, but might also prevent complications and potential consequences resulting in medicolegal litigation. One of the simulators in the field of flexible endoscopy is the GI Mentor II (see Figure 1). VR simulators have been used extensively in different fields of expertise before applying these procedures to patients. In the United States of America simulator training is mandated by the Accreditation Council for Graduate Medical Education (ACGME) in laparoscopic procedures for surgical residents [3]. The first step is to validate the simulator construct properly and verify its didactic value, before implementing simulators in teaching programmes or developing a new curriculum for flexible endoscopy around them.Figure 1.


Expert and construct validity of the Simbionix GI Mentor II endoscopy simulator for colonoscopy.

Koch AD, Buzink SN, Heemskerk J, Botden SM, Veenendaal R, Jakimowicz JJ, Schoon EJ - Surg Endosc (2007)

The GI Mentor II virtual reality simulator, the setup for training in lower endoscopy.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2169271&req=5

Fig1: The GI Mentor II virtual reality simulator, the setup for training in lower endoscopy.
Mentions: Training skills in endoscopy for diagnostic and therapeutic procedures is essential and requires a great deal of hands-on training [1]. Virtual reality (VR) simulators offer a promising option to train these skills extensively prior to training in real-life colonoscopy, without jeopardizing patients or causing them unnecessary discomfort [2]. The use of VR training prior to performing real flexible endoscopy on patients enables novice endoscopists to go through part of their proficiency curve before submitting patients to their relatively insufficient endoscopy skills. This might not only be advantageous for the patients undergoing endoscopy, but might also prevent complications and potential consequences resulting in medicolegal litigation. One of the simulators in the field of flexible endoscopy is the GI Mentor II (see Figure 1). VR simulators have been used extensively in different fields of expertise before applying these procedures to patients. In the United States of America simulator training is mandated by the Accreditation Council for Graduate Medical Education (ACGME) in laparoscopic procedures for surgical residents [3]. The first step is to validate the simulator construct properly and verify its didactic value, before implementing simulators in teaching programmes or developing a new curriculum for flexible endoscopy around them.Figure 1.

Bottom Line: The average time to reach the cecum was defined as one of the main test parameters as well as the number of times view of the lumen was lost.Novices lost view of the lumen significantly more often compared to the other groups, and the EndoBubble task was also completed significantly faster with increasing experience (Kruskal Wallis Test, p < 0.001).According to experts the simulator should be implemented in the training programme of novice endoscopists.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands. a.d.koch@erasmusmc.nl

ABSTRACT

Objectives: The main objectives of this study were to establish expert validity (a convincing realistic representation of colonoscopy according to experts) and construct validity (the ability to discriminate between different levels of expertise) of the Simbionix GI Mentor II virtual reality (VR) simulator for colonoscopy tasks, and to assess the didactic value of the simulator, as judged by experts.

Methods: Four groups were selected to perform one hand-eye coordination task (EndoBubble level 1) and two virtual colonoscopy simulations on the simulator; the levels were: novices (no endoscopy experience), intermediate experienced (<200 colonoscopies performed before), experienced (200-1,000 colonoscopies performed before), and experts (>1,000 colonoscopies performed before). All participants filled out a questionnaire about previous experience in flexible endoscopy and appreciation of the realism of the colonoscopy simulations. The average time to reach the cecum was defined as one of the main test parameters as well as the number of times view of the lumen was lost.

Results: Novices (N = 35) reached the cecum in an average time of 29:57 (min:sec), intermediate experienced (N = 15) in 5:45, experienced (N = 20) in 4:19 and experts (N = 35) in 4:56. Novices lost view of the lumen significantly more often compared to the other groups, and the EndoBubble task was also completed significantly faster with increasing experience (Kruskal Wallis Test, p < 0.001). The group of expert endoscopists rated the colonoscopy simulation as 2.95 on a four-point scale for overall realism. Expert opinion was that the GI Mentor II simulator should be included in the training of novice endoscopists (3.51).

Conclusion: In this study we have demonstrated that the GI Mentor II simulator offers a convincing realistic representation of colonoscopy according to experts (expert validity) and that the simulator can discriminate between different levels of expertise (construct validity) in colonoscopy. According to experts the simulator should be implemented in the training programme of novice endoscopists.

Show MeSH