King Neil, Kunac Anastasia, Johnsen Erik, Gallina Gregory, Merchant Aziz M
Division of General Surgery, Rutgers-New Jersey Medical School, Newark, NJ, 07103, USA.
Division of Trauma and Critical Care, Rutgers-New Jersey Medical School, Newark, NJ, 07103, USA.
Surg Endosc. 2016 Nov;30(11):4871-4879. doi: 10.1007/s00464-016-4824-y. Epub 2016 Feb 23.
The American Board of Surgery will require graduating surgical residents to achieve proficiency in endoscopy. Surgical simulation can help residents to prepare for this proficiency test, accelerate skill acquisition, shorten the learning, and improve patient safety. Currently, endoscopic simulators are extremely cost-prohibitive. We therefore designed an inexpensive physical endoscopic simulator to (1) facilitate Fundamentals of Endoscopic Surgery skills training and (2) teach basic colonoscopy skills, for <$200.00.
We constructed the Rutgers Open Source Colonoscopy Simulator (ROSCO) from easily acquired commercial materials. For construct validation, we compared novices to experts in a two-arm non-randomized study. Each participant performed the five tasks and a full cecal intubation on the simulator. Face and content validity surveys were taken by the experts, after the construct validity study to determine the simulator's ability to achieve the intended task with "realism." Data were collected on (1) cost and construction, (2) time to completion of individual tasks, (3) percentage of task completion, and (4) survey statistics.
Our simulator requires no advanced expertise, costs $62.77 US, and weighs 8.5 pounds. The ROSCO simulator was clearly able to distinguish expert from novice. Expert task times for completing all five tasks, performing the loop reduction, and reaching the splenic and hepatic flexures on the simulator were significantly better than novice times (p < 0.05). All participants were able to complete all five tasks on the simulator 100 % of the time. Three out of five experts "Agreed" or "Strongly Agreed" with five out of the six statements regarding the simulator's teaching ability. Four out of five experts rated each of the five specific aspects of the simulator as "Realistic" or "Very Realistic."
We have designed a low-cost colonoscopy simulator with easily available materials and which requires very little advanced construction expertise and have demonstrated construct, face, and content validity. We believe this will have broad impact for endoscopic simulation, surgical education, and health education cost.
美国外科委员会将要求即将毕业的外科住院医师在内镜检查方面达到熟练水平。手术模拟可以帮助住院医师为这项熟练度测试做准备，加速技能习得，缩短学习时间，并提高患者安全性。目前，内镜模拟器极其昂贵。因此，我们设计了一种价格低廉的实体内镜模拟器，成本低于200美元，用于：（1）促进内镜外科学基础技能培训；（2）教授基本的结肠镜检查技能。
我们用容易获得的商业材料构建了罗格斯开源结肠镜模拟器（ROSCO）。为进行结构效度验证，我们在一项双臂非随机研究中比较了新手和专家。每位参与者在模拟器上执行五项任务并完成一次完整的盲肠插管。在结构效度研究之后，专家们进行了表面效度和内容效度调查，以确定模拟器以“逼真度”完成预期任务的能力。收集的数据包括：（1）成本与构建；（2）完成各个任务的时间；（3）任务完成百分比；（4）调查统计数据。
我们的模拟器不需要先进的专业知识，成本为62.77美元，重8.5磅。ROSCO模拟器能够清晰地区分专家和新手。专家在模拟器上完成所有五项任务、进行袢复位以及到达脾曲和肝曲的任务时间明显优于新手（p < 0.05）。所有参与者都能在模拟器上100%的时间内完成所有五项任务。五分之三的专家对关于模拟器教学能力的六项陈述中的五项“同意”或“强烈同意”。五分之四的专家将模拟器的五个具体方面中的每一个都评为“逼真”或“非常逼真”。
我们设计了一种低成本的结肠镜模拟器，其材料容易获得，几乎不需要先进的构建专业知识，并证明了其结构效度、表面效度和内容效度。我们相信这将对内镜模拟、外科教育和健康教育成本产生广泛影响。
