Qiao Weiguang, Bai Yang, Lv Ruxi, Zhang Wendi, Chen Yuqing, Lei Shan, Zhi Fachao
Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, China.
School of Traditional Chinese Medicine, Southern Medical University, Research Institute of Traditional Chinese Medicine, Guangdong Medical College, Zhanjiang City, Guangdong Province, China.
PLoS One. 2014 Feb 21;9(2):e89224. doi: 10.1371/journal.pone.0089224. eCollection 2014.
Advances in virtual endoscopy simulators have paralleled an interest in medical simulation for gastrointestinal endoscopy training.
The primary objective was to determine whether the virtual endoscopy simulator training could improve the performance of novices.
A systematic review.
Randomized controlled trials (RCTs) that compared virtual endoscopy simulator training with bedside teaching or any other intervention for novices were collected.
Novice endoscopists.
The PRISMA statement was followed during the course of the research. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and ScienceDirect were searched (up to July 2013). Data extraction and assessment were independently performed.
Independent procedure completion, total procedure time and required assistance.
Fifteen studies (n = 354) were eligible for inclusion: 9 studies designed for colonoscopy training, 6 for gastroscopy training. For gastroscopy training, procedure completed independently was reported in 87.7% of participants in simulator training group compared to 70.0% of participants in control group (1 study; 22 participants; RR 1.25; 95% CI 1.13-1.39; P<0.0001). For colonoscopy training, procedure completed independently was reported in 89.3% of participants in simulator training group compared to 88.9% of participants in control group (7 study; 163 participants; RR 1.10; 95% CI 0.88-1.37; P = 0.41; I(2) = 85%).
The included studies are quite in-homogeneous with respect to training schedule and procedure.
Virtual endoscopy simulator training might be effective for gastroscopy, but so far no data is available to support this for colonoscopy.
虚拟内镜模拟器的进展与胃肠内镜培训医学模拟的兴趣同步。
主要目的是确定虚拟内镜模拟器培训是否能提高新手的操作表现。
系统评价。
收集比较虚拟内镜模拟器培训与床边教学或新手的任何其他干预措施的随机对照试验(RCT)。
新手内镜医师。
研究过程遵循PRISMA声明。检索Cochrane对照试验中央登记册、MEDLINE、EMBASE和ScienceDirect(截至2013年7月)。数据提取和评估独立进行。
独立完成操作、总操作时间和所需协助。
15项研究(n = 354)符合纳入标准:9项研究用于结肠镜检查培训,6项用于胃镜检查培训。对于胃镜检查培训,模拟器培训组87.7%的参与者报告独立完成操作,而对照组为70.0%(1项研究;22名参与者;RR 1.25;95%CI 1.13 - 1.39;P<0.0001)。对于结肠镜检查培训,模拟器培训组89.3%的参与者报告独立完成操作,而对照组为88.9%(7项研究;163名参与者;RR 1.10;95%CI 0.88 - 1.37;P = 0.41;I(2)=85%)。
纳入的研究在培训计划和操作方面相当不均匀。
虚拟内镜模拟器培训可能对胃镜检查有效,但目前尚无数据支持对结肠镜检查有效。