Background and study aims: Simulators are increasingly used in skills training for physicians; however data on systematic evaluation of the performance of these simulators are scarce compared with those used in aviation. The objectives of this study were to determine the expert validity, the construct validity, and the training value of the novel Olympus simulator as judged by experts.
Patients and methods: Participants were novices and experts. Novices had no prior experience in flexible endoscopy; experts had all performed more than 1000 colonoscopies. Participants filled out a questionnaire on their impression of the realism of the colonoscopy exercises performed. These included a dexterity exercise and a virtual colonoscopy. Test parameters used were points acquired in a game, time to reach the cecum, maximum insertion force, and ”patient pain.”
Results: Novices (n = 26) scored a median of 973 points (range – 118 – 1393), experts (n = 23) scored 1212 points (range 89 – 1375). This difference did not reach significance (P = 0.073). Experts performed virtual colonoscopy significantly faster than novices (220 vs. 780 s, P < 0.001) but used more insertion force (11.8 vs. 11.6 N; P = 0.147). Maximum pain score was higher in the expert group: 86 % vs. 73 %. (P = 0.018). The realism was graded 6.5 on a 10-point scale. Experts considered the Olympus simulator beneficial for the training of novice endoscopists.
Conclusions: The novel Olympus simulator discriminates excellently between the measured levels of expertise. The prototype offers a good realistic representation of colonoscopy according to experts. Although the software development is continuing, the device can already be implemented in the training program of novice endoscopists.
References
-
1
Bond J H, Frakes J T.
Who should perform colonoscopy? How much training is needed?.
Gastrointest Endosc.
1999;
49
657-659
-
2
BSG Guidelines .
Gastro-intestinal endoscopy in general practice.
Gut.
1994;
35
1342
-
3
Teague R, Soehendra N, Carr-Locke D. et al .
Setting standards for colonoscopic teaching and training.
J Gastroenterol Hepatol.
2002;
17 (Suppl)
S50-S53
-
4
Grantcharov T P, Carstensen L, Schulze S.
Objective assessment of gastrointestinal endoscopy skills using a virtual reality simulator.
JSLS.
2005;
9
130-133
-
5
Thomas-Gibson S, Williams C B.
Colonoscopy training--new approaches, old problems.
Gastrointest Endosc Clin N Am.
2005;
15
813-827
-
6
Koch A D, Buzink S N, Heemskerk J. et al .
Expert and construct validity of the Simbionix GI Mentor II endoscopy simulator for colonoscopy.
Surg Endosc.
2008;
22
158-162. Epub 2007 May 22, 2007
-
7
Buzink S N, Koch A D, Heemskerk J. et al .
Acquiring basic endoscopy skills by training on the GI Mentor II.
Surg Endosc.
2007;
21
1996-2003
-
8
Sedlack R E, Kolars J C, Alexander J A.
Computer simulation training enhances patient comfort during endoscopy.
Clin Gastroenterol Hepatol.
2004;
2
348-352
-
9
Sedlack R E, Kolars J C.
Validation of a computer-based colonoscopy simulator.
Gastrointest Endosc.
2003;
57
214-218
-
10
Datta V, Mandalia M, Mackay S, Darzi A.
The PreOp flexible sigmoidoscopy trainer. Validation and early evaluation of a virtual reality based system.
Surg Endosc.
2002;
16
1459-1463
-
11
Felsher J J, Olesevich M, Farres H. et al .
Validation of a flexible endoscopy simulator.
Am J Surg.
2005;
189
497-500
-
12
Mahmood T, Darzi A.
A study to validate the colonoscopy simulator.
Surg Endosc.
2003;
17
1583-1589
-
13
Ahlberg G, Hultcrantz R, Jaramillo E. et al .
Virtual reality colonoscopy simulation: a compulsory practice for the future colonoscopist?.
Endoscopy.
2005;
37
1198-1204
-
14
Roberts K E, Bell R L, Duffy A J.
Evolution of surgical skills training.
World J Gastroenterol.
2006;
12
3219-3224
-
15
Carter F J, Schijven M P, Aggarwal R. et al .
Consensus guidelines for validation of virtual reality surgical simulators.
Surg Endosc.
2005;
19
1523-1532
-
16 Field A. Discovering statistics using SPSS. Sage Publications 2005
A. D. Koch, MD
Erasmus MC – University Medical Centre
Department of Gastroenterology and Hepatology
PO box 2040
3000 CA Rotterdam, The Netherlands
Fax: +31-10-4634682
Email: a.d.koch@erasmusmc.nl
