Buzink S N, Koch A D, Heemskerk J, Botden S M B I, Goossens R H M, de Ridder H, Schoon E J, Jakimowicz J J
Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15, 2628 CE, Delft, The Netherlands.
Surg Endosc. 2007 Nov;21(11):1996-2003. doi: 10.1007/s00464-007-9297-6. Epub 2007 May 5.
Achieving proficiency in flexible endoscopy requires a great amount of practice. Virtual reality (VR) simulators could provide an effective alternative for clinical training. This study aimed to gain insight into the proficiency curve for basic endoscope navigation skills with training on the GI Mentor II.
For this study, 30 novice endoscopists performed four preset training sessions. In each session, they performed one EndoBubble task and managed multiple VR colonoscopy cases (two in first session and three in subsequent sessions). Virtual reality colonoscopy I-3 was repeatedly performed as the last VR colonoscopy in each session. The assignment for the VR colonoscopies was to visualize the cecum as quickly as possible without causing patient discomfort. Five expert endoscopists also performed the training sessions. Additionally, the performance of the novices was compared with the performance of 20 experienced and 40 expert endoscopists.
The novices progressed significantly, particularly in the time required to accomplish the tasks (p < 0.05, Friedman's analysis of variance [ANOVA], p < 0.05, Wilcoxon signed ranks). The experts did not improve significantly, except in the percentage of time the patient was in excessive pain. For all the runs, the performance of the novices differed significantly from that of both the experienced and the expert endoscopists (p < 0.05, Mann-Whitney U). The performance of the novices in the latter runs differed less from those of both the experienced and the expert endoscopists.
The study findings demonstrate that training in both VR colonoscopy and EndoBubble tasks on the GI Mentor II improves the basic endoscope navigation skills of novice endoscopists significantly.
熟练掌握软性内镜检查需要大量的练习。虚拟现实（VR）模拟器可为临床培训提供一种有效的替代方法。本研究旨在深入了解使用GI Mentor II进行培训时基本内镜导航技能的熟练程度曲线。
在本研究中，30名新手内镜医师进行了四次预设培训课程。在每次课程中，他们执行一项EndoBubble任务并处理多个VR结肠镜检查病例（第一次课程处理两个，后续课程处理三个）。每次课程的最后一项VR结肠镜检查均重复进行虚拟现实结肠镜检查I-3。VR结肠镜检查的任务是在不引起患者不适的情况下尽快观察到盲肠。五名专家内镜医师也进行了这些培训课程。此外，还将新手的表现与20名经验丰富的内镜医师和40名专家内镜医师的表现进行了比较。
新手有显著进步，尤其是在完成任务所需的时间方面（p < 0.05，弗里德曼方差分析[ANOVA]，p < 0.05，威尔科克森符号秩检验）。专家们没有显著改善，除了患者处于极度疼痛状态的时间百分比。在所有的操作中，新手的表现与经验丰富的内镜医师和专家内镜医师均有显著差异（p < 0.05，曼-惠特尼U检验）。新手在后续操作中的表现与经验丰富的内镜医师和专家内镜医师的差异较小。
研究结果表明，在GI Mentor II上进行VR结肠镜检查和EndoBubble任务的培训可显著提高新手内镜医师的基本内镜导航技能。
