Department of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.
Gastrointest Endosc. 2012 Nov;76(5):993-1002. doi: 10.1016/j.gie.2012.07.024. Epub 2012 Sep 8.
Computer-based endoscopy simulators may enable trainees to learn and develop technical skills before performing on patients. Simulators require validation as adequate models of live endoscopy before being used for training or assessment purposes.
To evaluate content and criterion validity of the CAE EndoscopyVR Simulator colonoscopy and EGD modules as predictors of clinical endoscopic skills.
Prospective, observational, non-randomized, parallel cohort study.
Single academic center with accredited gastroenterology training program.
Five novice first-year gastroenterology fellows and 6 expert gastroenterology attending physicians.
Participants performed 18 simulated colonoscopies and 6 simulated EGDs. The simulator recorded objective performance parameters. Participants then completed feedback surveys.
The 57 objective performance parameters measured by the endoscopy simulator were compared between the two study groups. Novice and expert survey responses were analyzed.
Significant differences between novice and expert performance were detected in only 19 of 57 (33%) performance metrics. Eight of these 19 (42%) were time-related metrics, such as total procedure time, time to anatomic landmarks, and time spent in contact with GI mucosa. Of 49 non-time related measures, the few additional statistically significant differences between novices and experts involved air insufflation, sedation management, endoscope force, and patient comfort. These findings are of uncertain clinical significance. Survey data found multiple aspects of the simulation to be unrealistic compared with human endoscopy.
Small sample size.
The CAE EndoscopyVR Simulator displays poor content and criterion validity and is thereby incapable of predicting skill during in vivo endoscopy.
基于计算机的内镜模拟训练器可以让学员在为患者进行操作之前，学习并掌握技术技能。在将模拟训练器用于培训或评估目的之前，需要对其作为真实内镜的模拟程度进行验证。
评估 CAE 内镜 VR 模拟器结肠镜和上消化道内镜模块的内容和标准效度，以预测临床内镜技能。
前瞻性、观察性、非随机、平行队列研究。
具有认证的胃肠病学培训项目的单一学术中心。
5 名新手第一年的胃肠病学研究员和 6 名专家级胃肠病学主治医生。
参与者进行了 18 次模拟结肠镜检查和 6 次模拟上消化道内镜检查。模拟器记录了客观的性能参数。参与者随后完成了反馈调查。
在这两个研究组之间比较了内镜模拟器测量的 57 个客观性能参数。分析了新手和专家的调查反馈。
在 57 项性能指标中，仅在 19 项（33%）性能指标中检测到新手和专家之间的显著差异。其中 8 项（42%）是与时间相关的指标，例如总手术时间、到达解剖标志的时间和与胃肠道黏膜接触的时间。在 49 项非时间相关的测量中，新手和专家之间的少数其他统计学显著差异涉及空气注入、镇静管理、内镜力和患者舒适度。这些发现具有不确定的临床意义。调查数据发现，与人体内镜相比，模拟的多个方面不切实际。
样本量小。
CAE 内镜 VR 模拟器显示出较差的内容和标准效度，因此无法预测体内内镜操作的技能。
