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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(06): E815-E823
DOI: 10.1055/a-1814-9747
Original article

Assessment of esophagogastroduodenoscopy skills on simulators before real-life performance

Anders Bo Nielsen
1   Odense University Hospital, SimC – Simulation Center, Odense, Denmark
2   Odense University Hospital, Department of Medical Gastroenterology, Odense, Denmark
3   University of Southern Denmark, Department of Clinical Research, Odense, Denmark
,
Finn Møller Pedersen
2   Odense University Hospital, Department of Medical Gastroenterology, Odense, Denmark
3   University of Southern Denmark, Department of Clinical Research, Odense, Denmark
,
Christian B. Laursen
4   Odense University Hospital, Department of Respiratory Medicine, Odense, Denmark
5   University of Southern Denmark, Respiratory Research Unit, Odense, Denmark
,
Lars Konge
6   Capital Region of Denmark – Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark
,
Stig Laursen
2   Odense University Hospital, Department of Medical Gastroenterology, Odense, Denmark
3   University of Southern Denmark, Department of Clinical Research, Odense, Denmark
› Author AffiliationsTRIAL REGISTRATION: Prospective study at https://www.clinicaltrials.gov/
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Abstract

Background and study aims Operator competency is essential for esophagogastroduodenoscopy (EGD) quality, which makes appropriate training with a final test important. The aims of this study were to develop a test for assessing skills in performing EGD, gather validity evidence for the test, and establish a credible pass/fail score.

Methods An expert panel developed a practical test using the Simbionix GI Mentor II simulator (3 D Systems) and an EGD phantom (OGI 4, CLA Medical) with a diagnostic (DP) and a technical skills part (TSP) for a prospective validation study. During the test a supervisor measured: 1) total time; 2) degree of mucosal visualization; and 3) landmarks and pathology identification. The contrasting groups standard setting method was used to establish a pass/fail score.

Results We included 15 novices (N), 10 intermediates (I), and 10 experienced endoscopists (E). The internal structure was high with a Cronbach’s alpha of 0.76 for TSP time consumption and 0.74 for the identification of landmarks.

Mean total times, in minutes, for the DP were N 15.7, I 11.3, and E 7.0, and for TSP., they were N 7.9, I 8.9, and E 2.9. The total numbers of identified landmarks were N 26, I 41, and E 48. Mean visualization percentages were N 80, I 71, and E 71. A pass/fail standard was established requiring identification of all landmarks and performance of the TSP in < 5 minutes. All experienced endoscopists passed, while none of the endoscopists in the other categories did.

Conclusions We established a test that can distinguish between participants with different competencies. This enables an objective and evidence-based approach to assessment of competencies in EGD.



Publication History

Received: 20 October 2021

Accepted after revision: 30 March 2022

Accepted Manuscript online:
01 April 2022

Article published online:
10 June 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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