Endoscopy 2023; 55(S 02): S5
DOI: 10.1055/s-0043-1765001
Abstracts | ESGE Days 2023
Opening session with best abstracts
20/04/2023, 11:30 – 12:30 Auditorium

Training Esophagogastroduodenoscopy Skills: A Randomized, Multi-center Trial of Simulation-Based Training versus Clinical Training with 1183 procedures

A. B. Nielsen
1   SimC – Simulation Center, Odense University Hospital, Denmark, Odense, Denmark
2   Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark
3   Department of Clinical Research, University of Southern Denmark, Odense, Denmark
,
F. M. Pedersen
2   Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark
,
L. Konge
4   Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark
,
C. B. Laursen
5   Department of Respiratory Medicine, Odense University Hospital, Denmark, Odense, Denmark
6   Odense Respiratory Research Unit (ODIN), University of Southern Denmark, Odense, Denmark
,
S. B. Laursen
3   Department of Clinical Research, University of Southern Denmark, Odense, Denmark
7   Department of Medical Gastroenterology, Odense University Hospital, Denmark, Odense, Denmark
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    Aims Simulation-based training (SBT) seems promising to ensure the quality of esophagogastroduodenoscopy (EGD) skills, but the effects remain unknown. This study aimed to explore: 1) the impact of SBT on the necessary number of supervised clinical procedures before independent practice, 2) the cost-effectiveness of SBT in EGD compared to clinical bedside training (CBT) and 3) the effects on patient satisfaction.

    Methods EGD novices were randomized to SBT (including passing a test [1]) before CBT or CBT only in a Danish multicenter randomized controlled trial from December 2020 to January 2022. Need for supervision, the number of procedures required for independent practice, and patient satisfaction were monitored during participants’ first 50 clinical procedures. The costs of both arms were estimated for cost-effectiveness analysis using a micro-costing approach.

    Results Twenty-five physicians from nine departments performed 1183 EGDs with 661 patient satisfaction surveys. There was a significant difference in the number of procedures required for independent practice between SBT (median 31 (95% CI: 25-37)) and CBT (median 44 (95% CI: 33-55), p=0.006) and a lower need for supervision when comparing learning curves for the two groups (p=0.012). The incremental cost-effectiveness ratio showed savings of 12 (95% CI: -158-191) USD/procedure when using SBT including monetary costs of 2993 (95% CI: 2678-3628) USD in the SBT group and 3150 (95% CI: 2520-5355) USD in the CBT group. No difference in patient satisfaction was seen between the groups.

    Conclusions SBT improves competencies and is potentially more cost-effective. This study underlines the benefits of SBT and supports the implementation of routine use of SBT in learning EGD.


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    Conflicts of interest

    Authors do not have any conflict of interest to disclose.


    Publication History

    Article published online:
    14 April 2023

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