Download PDF
CC BY 4.0 · Surg J (N Y) 2022; 08(01): e80-e85
DOI: 10.1055/s-0042-1743517
Original Article

Resident Endoscopy Experience Correlates Poorly with Performance on a Virtual Reality Simulator

Kurun Partap S. Oberoi
1   Division of General Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
,
Michael T. Scott 
2   Division of General Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
,
Jacob Schwartzman
1   Division of General Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
,
Jasmine Mahajan 
1   Division of General Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
,
Nell Maloney Patel
2   Division of General Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
,
Melissa M. Alvarez-Downing 
1   Division of General Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
,
Aziz M. Merchant 
1   Division of General Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
,
Anastasia Kunac 
3   Division of Trauma and Surgical Critical Care, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Background Endoscopy training has become increasingly emphasized during general surgery residency as reflected by introduction of the Fundamentals of Endoscopic Surgery (FES) examination, which includes testing of skills on virtual reality (VR) simulators. Although studies exist to assess the ability of the simulator to differentiate between novices and experienced endoscopists, it is not well understood how simulators can differentiate skills among resident cohort.

Objective To assess the utility of the VR simulator, we evaluated the correlation between resident endoscopy experience and performance on two VR simulator colonoscopy modules on the GI-BRONCH Mentor (Simbionix Ltd, Airport City, Israel).

Methods Postgraduate years 2 to 5 residents completed “easy” and “difficult” VR colonoscopies, and performance metrics were recorded from October 2017 to February 2018 at Rutgers' two general surgery residency programs. Resident endoscopy experience was obtained through Accreditation Council for Graduate Medical Education case logs. Correlations between resident endoscopy experience and VR colonoscopy performance metrics were assessed using Spearman's rho (ρ) correlation statistic and bivariate logistic regression.

Results Fifty-five residents out of 65 (84.6%) eligible participants completed the study. There were limited correlations found between resident endoscopy experience and FES performance metrics and no correlations were found between resident endoscopy experience and binary metrics of colonoscopy—ability to complete colonoscopy, ability to retroflex, and withdrawal time of less than 6 minutes.

Conclusion The VR simulator may have a limited ability to discriminate between experience levels among resident cohort. Future studies are needed to further understand how well the VR simulator metrics correlate with resident endoscopy experience.

Keywords

GI Mentor - colonoscopy - surgical - simulation - endoscopy - residency training

Authors' Contribution

A.K., A.M.M., and K.P.S.O. were responsible for the concept and execution of the study discussed in this report. K.P.S.O. and M.T.S. were responsible for data collection. K.P.S.O., J.S., A.K., A.M.M., M.M.A., M.T.S., and N.M.P. participated in data interpretation. J.S. performed the statistical analysis. K.P.S.O., A.K., M.M.A., and J.M. were responsible for the writing, preparation, and editing of this report.


Author Disclaimer

The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.




Publication History

Received: 04 February 2021

Accepted: 30 December 2021

Article published online:
03 March 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 ABS The American Board of Surgery: Training & Certification > General Surgery Training Requirements > Flexible Endoscopy Curriculum. 2017
    PubMedGoogle Scholar
  • 2 SAGES The Fundamentals of Endoscopic Surgery: FAQ'S. 2018
    PubMedGoogle Scholar
  • 3 Gardner AK, Scott DJ, Willis RE. et al. Is current surgery resident and GI fellow training adequate to pass FES?. Surg Endosc 2017; 31 (01) 352-358
    CrossrefPubMedGoogle Scholar
  • 4 Gardner AK, Ujiki MB, Dunkin BJ. Passing the Fundamentals of Endoscopic Surgery (FES) exam: linking specialty choice and attitudes about endoscopic surgery to success. Surg Endosc 2018; 32 (01) 225-228
    CrossrefPubMedGoogle Scholar
  • 5 Franklin BR, Placek SB, Gardner AK. et al. Preparing for the American Board of Surgery Flexible Endoscopy Curriculum: Development of multi-institutional proficiency-based training standards and pilot testing of a simulation-based mastery learning curriculum for the Endoscopy Training System. Am J Surg 2017
    PubMedGoogle Scholar
  • 6 Gearhart S, Marohn M, Ngamruengphong S. et al. Development of a train-to-proficiency curriculum for the technical skills component of the Fundamentals of Endoscopic Surgery exam. Surg Endosc 2018; 32 (07) 3070-3075
    CrossrefPubMedGoogle Scholar
  • 7 Guzzetta AA, Weis JJ, Hennessy SA. et al. Proficiency-based preparation significantly improves FES certification performance. Surg Endosc 2018; 32 (11) 4451-4457
    CrossrefPubMedGoogle Scholar
  • 8 SAGES FUNDAMENTALS OF ENDOSCOPIC SURGERY: PASSING THE EXAM. 2016
    PubMedGoogle Scholar
  • 9 Fayez R, Feldman LS, Kaneva P, Fried GM. Testing the construct validity of the Simbionix GI Mentor II virtual reality colonoscopy simulator metrics: module matters. Surg Endosc 2010; 24 (05) 1060-1065
    CrossrefPubMedGoogle Scholar
  • 10 Vassiliou MC, Kaneva PA, Poulose BK. et al. Global Assessment of Gastrointestinal Endoscopic Skills (GAGES): a valid measurement tool for technical skills in flexible endoscopy. Surg Endosc 2010; 24 (08) 1834-1841
    CrossrefPubMedGoogle Scholar
  • 11 Rex DK, Schoenfeld PS, Cohen J. et al. Quality indicators for colonoscopy. Gastrointest Endosc 2015; 81 (01) 31-53
    CrossrefPubMedGoogle Scholar
  • 12 Felsher JJ, Olesevich M, Farres H. et al. Validation of a flexible endoscopy simulator. Am J Surg 2005; 189 (04) 497-500
    CrossrefPubMedGoogle Scholar
  • 13 Grantcharov TP, Carstensen L, Schulze S. Objective assessment of gastrointestinal endoscopy skills using a virtual reality simulator. JSLS 2005; 9 (02) 130-133
    PubMedGoogle Scholar
  • 14 Adamsen S, Funch-Jensen PM, Drewes AM, Rosenberg J, Grantcharov TP. A comparative study of skills in virtual laparoscopy and endoscopy. Surg Endosc 2005; 19 (02) 229-234
    CrossrefPubMedGoogle Scholar
  • 15 Clark JA, Volchok JA, Hazey JW, Sadighi PJ, Fanelli RD. Initial experience using an endoscopic simulator to train surgical residents in flexible endoscopy in a community medical center residency program. Curr Surg 2005; 62 (01) 59-63
    CrossrefPubMedGoogle Scholar
  • 16 Kim S, Spencer G, Makar GA. et al. Lack of a discriminatory function for endoscopy skills on a computer-based simulator. Surg Endosc 2010; 24 (12) 3008-3015
    CrossrefPubMedGoogle Scholar
  • 17 Faulx AL, Lightdale JR, Acosta RD. et al; ASGE Standards of Practice Committee. Guidelines for privileging, credentialing, and proctoring to perform GI endoscopy. Gastrointest Endosc 2017; 85 (02) 273-281
    CrossrefPubMedGoogle Scholar
  • 18 American Educational Research Association, American Psychological Association, and National Council on Measurement in Education. Standards for Educational and Psychological Testing. 1st ed.. Washington, DC: Amer Educational Research Association; April 1, 2014
    Google Scholar
  • 19 Noureldin YA, Sweet RM. A call for a shift in theory and terminology for validation studies in urological education. J Urol 2018; 199 (03) 617-620
    CrossrefPubMedGoogle Scholar
  • 20 Noureldin YA, Lee JY, McDougall EM, Sweet RM. Competency-based training and simulation: making a “valid” argument. J Endourol 2018; 32 (02) 84-93
    CrossrefPubMedGoogle Scholar
  • 21 Balla F, Garwe T, Motghare P. et al. Evaluating coding accuracy in general surgery residents' Accreditation Council for Graduate Medical Education procedural case logs. J Surg Educ 2016; 73 (06) e59-e63
    CrossrefPubMedGoogle Scholar
  • 22 Naik ND, Abbott EF, Aho JM. et al. The ACGME Case Log System may not accurately represent operative experience among general surgery interns. J Surg Educ 2017; 74 (06) e106-e110
    CrossrefPubMedGoogle Scholar
  • 23 Nygaard RM, Daly SR, Van Camp JM. General surgery resident case logs: do they accurately reflect resident experience?. J Surg Educ 2015; 72 (06) e178-e183
    CrossrefPubMedGoogle Scholar