Abstract
Background
The Texas Association of Surgical Skills Laboratories (TASSL) is a nonprofit consortium of surgical skills training centers for the accredited surgery residency programs in Texas. A training and research collaborative was forged between TASSL members and Simbionix (Cleveland, OH, USA) to assess the feasibility and efficacy of a multicenter, simulation- and Web-based flexible endoscopy training curriculum using shared GI Mentor II systems.
Methods
Two GI Mentor II flexible endoscopy simulators were provided for the study, and four institutions, namely, the University of Texas Health Science Center–San Antonio (UTHSCSA), Texas A & M University (TAMU), Methodist Hospital (MHD), and Brooke Army Medical Center (BAMC), agreed to share them. One additional site, University of Texas Southwestern (UTSW), already owned a device and participated during the study period. Postgraduate years (PGYs) 1 to 4 subjects completed pre- and posttraining questionnaires and one pre- and posttraining trial of Colonoscopy Case Module 1. EndoBubble 1 and 2 tasks with predefined, expert-derived levels were used for training. Pre- and posttesting performance data were recorded on the simulator and by the Global Assessment of Gastrointestinal Endoscopic Skills (GAGES). All study materials were available through the TASSL Web site. Pre- and posttest comparisons were made by paired t-test.
Results
The curriculum was completed successfully by 41 participants from four institutions. The mean number of trials to proficiency was 13 ± 10 for EndoBubble 1 and 23 ± 16 for EndoBubble 2. Significant improvements from pre- to posttraining were seen in cecal intubation time (229 ± 97 vs. 150 ± 57 s; p < 0.001), total time (454 ± 147 vs. 320 ± 115 s; p < 0.001), screening efficiency (85% ± 12% vs. 91% ± 5%; p < 0.002), GAGES scores (15 vs. 19; p < 0.001), subjects’ endoscopy self-rating scores (1.5 ± 1.0 vs. 2.7 ± 0.6; range, 0–4; p < 0.001), and comfort level with flexible endoscopy skills (3.4 ± 3.0 vs. 7.2 ± 1.2; range, 0–8; p < 0.001).
Conclusions
The feasibility of sharing educational and training resources among institutions was demonstrated. Likewise, the concept of “mobile simulation” appears to be useful and effective, with three of the four institutions involved successfully in implementing the training curriculum during a fixed period. Additionally, subjects who completed the training demonstrated both subjective and objective improvements in flexible endoscopy skills.
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Acknowledgments
This project was supported through educational grants from Covidien. The authors thank Simbionix, Inc. for its cooperation and participation in this study.
Disclosures
Kent R. Van Sickle is a consultant for Davol, Inc and has received an education grant from Covidien. Daniel Scott is a consultant for Accelerated Technologies, Inc. and NeatStitch, Inc. He has a licensing agreement from Ethicon and has received research grants from Ethicon, Covidien, and Karl Storz, as well as equipment grants from Karl Storz. Brian Dunkin is a consultant for Covidien, Ethicon, and Apllo Endosurgery and has received a research grant from Covidien. Lauren Buck, Ross Willis, Alicia Mangram, Michael S. Truitt, Mohsen Shabahang, Scott Thomas, and Lee Trombetta have no conflicts of interest or financial ties to disclose.
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Van Sickle, K.R., Buck, L., Willis, R. et al. A multicenter, simulation-based skills training collaborative using shared GI mentor II systems: results from the Texas association of surgical skills laboratories (TASSL) flexible endoscopy curriculum. Surg Endosc 25, 2980–2986 (2011). https://doi.org/10.1007/s00464-011-1656-7
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DOI: https://doi.org/10.1007/s00464-011-1656-7