Part 1
The Erlanger Endo-Trainer

Introduction

Various issues in the field of endoscopy reinforce the need for adequate training of sufficient quality. Pressure is exerted from various sides: trainees are faced with limited time in which to gain experience in the various diagnostic and therapeutic techniques; endoscopists are required to stay in touch with the latest technological developments and treatment modalities; there are increased demands and restrictions from health reform systems which further limit time and investment possibilities. Furthermore, the risk of complications needs to be kept to a minimum in the light of the increasing legal pressure placed on endoscopists. Last but not least, the growing awareness of patients about the various treatment options and their associated risks is leading towards specific questioning about the ability of the individual endoscopist to carry out a particular procedure.

In existing training programs there are usually no qualitative criteria: requirements are commonly based on quantitative parameters, such as the number of procedures, and the methods of assessing quality are generally less structured. In a recent article on the topic of quality assurance in gastrointestinal endoscopy, O’Mahony et al. refer to the threshold number of procedures specified by the American Society of Gastrointestinal Endoscopy (ASGE) training committee, the Union of European Medical Specialists and the European Board of Gastroenterology [1]. In its statement on credentialing and granting privileges for gastrointestinal endoscopy, ASGE also addresses the issue of objective criteria of skill [2].

All these considerations, and the statements of gastrointestinal endoscopy societies, strongly emphasize the need for suitable lifelike training models. We present here our Erlanger Endo-Trainer, a lifelike model constructed from synthetic materials and integrating biogenic organs taken from slaughtered animals. The Erlanger Endo-Trainer has been shown to be suitable for both basic courses and training in sophisticated therapeutic endoscopic techniques [3].

References

• 1 O’Mahony S, Naylor G, Axon A. Quality assurance in gastrointestinal endoscopy.  Endoscopy. 2000;  32 483-488
• 2 American Society for Gastrointestinal Endoscopy. Guidelines for credentialing and granting privileges for gastrointestinal endoscopy. ASGE Publication No. 1012. Revised December 1997
• 3 Neumann M, Mayer G, Ell C, et al. The Erlangen Endo-Trainer: life-like simulation for diagnostic and interventional endoscopic retrograde cholangiography.  Endoscopy. 2000;  32 (11) 906-910
• 4 Freys S M, Heimbucher J, Fuchs K H. Teaching upper gastrointestinal endoscopy. The pig stomach.  Endoscopy. 1995;  27 73-76
• 5 Soehendra N, Binmoeller K F. Overview of interactive endoscopy simulators.  Endoscopy. 1992;  24 549-550
• 6 Bar-Meir S. A new endoscopic simulator.  Endoscopy. 2000;  32 898-900
• 7 Neumann M, Friedl S, Egger K, et al. Prospektive Evaluierung einer Score-Card für die Beurteilung der diagnostischen öGD: Inter-Observer-Varianz (abstract).  Z Gastroenterol. 2001 (in press); 
• 8 Neumann M, Friedl S, Egger K, et al. Prospektive Evaluierung einer Score-Card für die Beurteilung der diagnostischen öGD: Welche Parameter unterscheiden zwischen Untersuchern unterschiedlicher Erfahrung (abstract)?.  Z Gastroenterol. 2001 (in press);