LearnEndo: A Simulator for Autonomous Endoscopy Training with Software Based Supervision and Feedback

Aims High-quality endoscopy is essential for patient safety and effective diagnosis and treatment. Therefore, the ESGE guideline recommends the integration of simulation-based training [1]. However, conventional simulator training often requires direct supervision from experienced endoscopists, who may have limited time for teaching. To address this challenge and enhance training accessibility, we aimed to develop an autonomous endoscopy simulator that utilizes software-based supervision to enable independent practice with real-time feedback.

Methods A commercially available upper gastrointestinal tract (uGIT) dummy was modified by placing QR Codes at specific anatomic landmarks within the esophagus, stomach and duodenum. These locations were selected based on the updated Syndey protocol and ESGE recommendations for documentation of uGIT endoscopy [2] [3]. Furthermore a sophisticated software was developed to detect QR codes using a standard gastroscope, providing trainees with real-time feedback on their time needed and accuracy in locating anatomical landmarks. Trainees receive real-time visual and acoustic feedback in a gamified format. Performance metrics, including positional deviations, are recorded for analysis.

Results A novel endoscopy simulator was successfully developed and enables autonomous training with real-time visual and acoustic feedback. Initial testing with novice endoscopists demonstrated that the simulator provides a challenging, effective, and engaging learning environment. Trainees were able to navigate the virtual upper gastrointestinal tract and locate anatomical landmarks with increasing accuracy over time. The gamified format, featuring performance-based scores and progress tracking, motivated trainees to improve their performance independently. The software-based supervision system provided trainees with personalized feedback on their performance and facilitates self-directed learning and skill refinement

Conclusions This simulator has the potential to enhance endoscopic skills, improve patient safety, and enable self-directed learning and skill refinement by facilitating independent practice with real endoscopes.

To confirm the effectiveness of our simulator, a standardized and ethics committee-approved study to validate the success of the training and determine a learning curve is currently being conducted.

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

• References

• 1 Shah SC.. Improving the Endoscopic Detection and Management of Gastric Intestinal Metaplasia Through Training: A Practical Guide. Gastroenterology 2022; 163 (4): 806-811 Epub 2022 Aug 235931107PMC10027538
• 2 Antonelli G. et al. Training in basic gastrointestinal endoscopic procedures: a European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement. Endoscopy 2024; 56 (2): 131-150 Epub 2023 Dec 138040025
• 3 Bisschops R. et al. Performance measures for upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2016; 48 (9): 843-64 Epub 2016 Aug 2227548885

Publication History

Article published online:
27 March 2025