Can J Gastroenterol Hepatol. 2014 Apr;28(4):203-6. doi: 10.1155/2014/804367.
Colonoscopy simulators that enable one to perform computer-based virtual colonoscopy now exist. However, data regarding the effectiveness of this virtual training are limited.
To determine whether virtual reality simulator training translates into improved patient-based colonoscopy performance.
The present study was a prospective controlled trial involving 18 residents between postgraduate years 2 and 4 with no previous colonoscopy experience. These residents were assigned to receive 16 h of virtual reality simulator training or no training. Both groups were evaluated on their first five patient-based colonoscopies. The primary outcome was the number of proctor 'assists' required per colonoscopy. Secondary outcomes included insertion time, depth of insertion, cecal intubation rate, proctor- and nurse-rated competence, and patient-rated pain.
The simulator group required significantly fewer proctor assists than the control group (1.94 versus 3.43; P ≤ 0.001), inserted the colonoscope further unassisted (43 cm versus 24 cm; P=0.003) and there was a trend to intubate the cecum more often (26% versus 10%; P=0.06). The simulator group received higher ratings of competence from both the proctors (2.28 versus 1.88 of 5; P=0.02) and the endoscopy nurses (2.56 versus 2.05 of 5; P=0.001). There were no significant differences in proctor-, nurse- or patient-rated pain, or attention to discomfort.
Computer-based colonoscopy simulation in the initial stages of training improved novice trainees' patient-based colonoscopy performance.
现已有可进行基于计算机的虚拟结肠镜检查的结肠镜检查模拟器。然而，有关这种虚拟培训效果的数据有限。
确定虚拟现实模拟器培训是否可转化为基于患者的结肠镜检查性能的提高。
本研究是一项前瞻性对照试验，涉及 18 名无结肠镜检查经验的 2 至 4 年级住院医师。这些住院医师被分配接受 16 小时的虚拟现实模拟器培训或不接受培训。两组均在其前五次基于患者的结肠镜检查中进行评估。主要结局是每次结肠镜检查所需的检查者“协助”次数。次要结局包括插入时间、插入深度、盲肠插管率、检查者和护士评定的能力以及患者评定的疼痛。
模拟器组所需的检查者协助次数明显少于对照组（1.94 比 3.43；P ≤ 0.001），未辅助情况下插入结肠镜的深度更远（43cm 比 24cm；P=0.003），且盲肠插管的趋势更明显（26%比 10%；P=0.06）。模拟器组获得了更高的来自检查者（5 分中的 2.28 比 1.88；P=0.02）和内镜护士（5 分中的 2.56 比 2.05；P=0.001）的能力评定。在检查者、护士或患者评定的疼痛或对不适的关注度方面，没有显著差异。
在培训的初始阶段，基于计算机的结肠镜检查模拟提高了新手受训者的基于患者的结肠镜检查表现。
