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. 2022 Jun 10;10(6):E815-E823.
doi: 10.1055/a-1814-9747. eCollection 2022 Jun.

Assessment of esophagogastroduodenoscopy skills on simulators before real-life performance

Anders Bo Nielsen  1   2   3 , Finn Møller Pedersen  2   3 , Christian B Laursen  4   5 , Lars Konge  6 , Stig Laursen  2   3
Affiliations

Assessment of esophagogastroduodenoscopy skills on simulators before real-life performance

Anders Bo Nielsen et al. Endosc Int Open. .

Abstract

Background and study aims Operator competency is essential for esophagogastroduodenoscopy (EGD) quality, which makes appropriate training with a final test important. The aims of this study were to develop a test for assessing skills in performing EGD, gather validity evidence for the test, and establish a credible pass/fail score. Methods An expert panel developed a practical test using the Simbionix GI Mentor II simulator (3 D Systems) and an EGD phantom (OGI 4, CLA Medical) with a diagnostic (DP) and a technical skills part (TSP) for a prospective validation study. During the test a supervisor measured: 1) total time; 2) degree of mucosal visualization; and 3) landmarks and pathology identification. The contrasting groups standard setting method was used to establish a pass/fail score. Results We included 15 novices (N), 10 intermediates (I), and 10 experienced endoscopists (E). The internal structure was high with a Cronbach's alpha of 0.76 for TSP time consumption and 0.74 for the identification of landmarks. Mean total times, in minutes, for the DP were N 15.7, I 11.3, and E 7.0, and for TSP., they were N 7.9, I 8.9, and E 2.9. The total numbers of identified landmarks were N 26, I 41, and E 48. Mean visualization percentages were N 80, I 71, and E 71. A pass/fail standard was established requiring identification of all landmarks and performance of the TSP in < 5 minutes. All experienced endoscopists passed, while none of the endoscopists in the other categories did. Conclusions We established a test that can distinguish between participants with different competencies. This enables an objective and evidence-based approach to assessment of competencies in EGD.

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Conflict of interest statement

Competing interests The authors declare that they have no conflict of interest.

Figures

Fig. 1 a
Fig. 1 a
The Simbionix GI Mentor II virtual reality simulator. b Fundus tumor in the diagnostic part. c EndoBubble. d Phantom-based setup. e Suture retrieval. f Bead retrieval.
Fig. 2
Fig. 2
Box-and-whiskers plot illustrating the total point score for identification of landmarks and pathology in the diagnostic part and total time for the tool handling part for the three groups. Median, maximum, and minimum time/score are depicted. The dashed line shows the pass/fail score.
Fig. 3
Fig. 3
Pass/fail score for total time use for the tool handling part illustrated by the dashed line using the contrasting groups method.
See this image and copyright information in PMC

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