The Efficacy of a Newly Designed, Easy-to-Manufacture Training Simulator for Endoscopic Biopsy of the Stomach

Abstract

Background/aims: We developed a new endoscopic biopsy training simulator and determined its efficacy for improving the endoscopic biopsy skills of beginners.

Methods: This biopsy simulator, which presents seven biopsy sites, was constructed using readily available materials. We enrolled 40 participants: 14 residents, 11 first-year clinical fellows, 10 second-year clinical fellows, and five staff members. We recorded the simulation completion time for all participants, and then simulator performance was assessed via a questionnaire using the 7-point Likert scale.

Results: The mean times for completing the five trials were 417.7±138.8, 145.2±31.5, 112.7±21.9, and 90.5±20.0 seconds for the residents, first-year clinical fellows, second-year clinical fellows, and staff members, respectively. Endoscopists with less experience reported that they found this simulator more useful for improving their biopsy technique (6.8±0.4 in the resident group and 5.7±1.0 in the first-year clinical fellow group). The realism score of the simulator for endoscopic handling was 6.4±0.5 in the staff group.

Conclusions: This new, easy-to-manufacture endoscopic biopsy simulator is useful for biopsy training for beginner endoscopists and shows good efficacy and realism.

Keywords: Biopsy; Education; Endoscopy; Simulator; Training.

Fig. 1

View of the interior of the container without its lid and a schematic diagram. (A) The photograph shows the interior of the food container without its lid. (B) The design schematic. The numbers are in order of biopsy progression and indicate the following: the greater curvature (GC)/anterior wall (AW) of the lower body (LB) (1st site, arrow), the AW of the antrum (2nd site, arrow), the AW of the LB (3rd site, arrow), the lesser curvature (LC)/posterior wall (PW) of the LB (4th site, arrow), the PW of the mid-body (MB) (5th site, arrow), the LC of the MB (6th site, arrow), and the cardia (7th site, arrow). The corresponding locations of the biopsy sites (●), polyvinylchloride (PVC) bottle cap (gray spot), and the hole for the scope shaft (○) are shown.

Fig. 2

View of the completed biopsy simulation and magnified views of its components. (A) View of the completed biopsy simulation. (B) Interior view of the hole in the container wall for the passage of the scope shaft. (C) View of the distal end of the polyvinylchloride (PVC) hose with the container removed. Also visible is the silk sheet fastened by the bracket and hose. (D) View of the PVC bottle cap. (E) View of the small round magnetic foam tape with a snap fastener in situ in one of the seven biopsy sites.

Fig. 3

Typical sequence of the maneuver for picking up the snap fastener with the biopsy forceps and putting it into the polyvinylchloride (PVC) bottle cap. (A) Approach to the snap fastener. (B) Grasping and detaching the snap fastener. (C) Moving the snap fastener to the PVC bottle cap.

Fig. 4

Completion times for each trial for all the groups.