Face validation of a 3D printed model for endoscopic haemostasis training

Aims Training of the endoscopy workforce is needed to develop a skilled workforce to deliver first line therapy for acute upper gastrointestinal bleeding (AUGIB). Training is generally acquired through on the job training with real patients. However, high risk therapeutic situations are not always appropriate for trainees and regular access to unscheduled acute clinical situations is difficult. A survey UK endoscopy trainees showed AUGIB training in the UK is variable. The majority of gastroenterology trainees lacked confidence in haemostasis management and desired additional training [1]. We trialled an upper GI Therapeutic endo simulation station – TESS gastro (endotrainer, UK) to evaluate it’s realism and suitability for training in haemostasis.

Methods Questionnaires were distributed to 38 trainees attending a UK haemostasis training day using the TESS gastro (endotrainer, UK) for training stations in bleeding ulcer injection, haemostatic clip, variceal glue and variceal banding. The questionnaire assessed the trainees previous training and confidence in haemostasis techniques and their view on the realism and use of the model for training in haemostasis therapeutic techniques using a 10 point scale from strongly disagree (0) to strongly agree (10). Responses to questionnaires were voluntary and completely anonymised.

Results The response rate was 84% (3 incomplete, 3 not returned). 81% were certified endoscopists for diagnostic gastroscopy. The median score for confidence in independent management of an upper gastrointestinal bleed was 4/10. 81%, 72%, 97% and 88% of delegates had<9 prior experiences of applying haemostatic clips, injection of adrenaline, injection of gastric varix or banding of bleeding varices respectively. The median score for realism and the handling of the simulator was 7/10. The median score for ease of use and appropriateness of haemostasis training was 8/10. The median score for training in clip application, adrenaline injection, injection of gastric varix and banding of varices were 8, 8, 8 and 9/10 respectively. 88% of delegates responded positively that they would want to train using the simulator again in the future.

Conclusions TESS gastro (endotrainer UK), a 3D printed therapeutics simulator, was deemed easy to use and appropriate for training in haemostasis techniques. Trainees responded that the model could be used for training in clip application, adrenaline injection, injection of gastric varices and banding of varices. Further studies are required to evaluate effectiveness and durability of training with this model.

Publication History

Article published online:
27 March 2025

• References

• 1 Segal J. et al. Training in endotherapy for acute upper gastrointestinal bleeding: a UK-wide gastroenterology trainee survey. Frontline Gastroenterol 2020; 11 (6): 430-435