HOME
Return to Table of Contents
HIGH VERSUS LOW FIDELITY SIMULATION TRAINING IN GASTROENTEROLOGY: EXPERTISE DISCRIMINATION
CM Walsh1,4, MA Cooper2,4, L Rabeneck2,3,4, HCarnahan4
1Division of Gastroenterology, Hospital for Sick Children, and 2Sunnybrook Health Sciences Center; 3Cancer Care Ontario; 4Faculty of Medicine, University of Toronto, Toronto, Ontario
Background and Aims: Gastrointestinal endoscopy is a technically demanding procedure, requiring considerable training for optimal performance. Simulation training is an important solution to the challenge of patient safety, as it has the potential to facilitate novice skill acquisition in a low-risk environment. However, high-fidelity virtual reality simulators are expensive, limiting their application. This aim of this study was to determine whether a low-fidelity, bench top sigmoidoscopy simulator can distinguish between beginner and experienced endosocopists (construct validity) and to assess whether there is a correlation in performance on the low-fidelity versus high-fidelity sigmoidoscopy simulator.
METHODS: Participants included 13 beginners and 8 experienced endoscopists. The low-fidelity bench top simulator task involved navigating a real endoscope through a series of targets as accurately and quickly as possible. The high fidelity virtual reality (VR) simulator models navigation through a colon and provides both visual and haptic feedback related to the procedure. Performance measures included time to advance and expert assessment of performance. Beginners and experts were tested on both sigmoidoscopy simulators.
RESULTS: Experienced endoscopists performed significantly better than beginners on both simulators. Significant differences in favor of experts were found for insertion time on both the bench-top model and VR simulator (p<.03), and expert assessment of VR simulator performance (p<.03). Measures of performance correlated significantly on the low versus high-fidelity simulator (p<.03).
CONCLUSIONS: This low-fidelity bench top sigmoidoscopy simulator was capable of differentiating users based on their level of endoscopy experience. In addition, there was a significant correlation between individual’s performance on the low-fidelity and high-fidelity models. Further studies are needed to determine if training on a low-fidelity simulator confers the same benefit as training on a high-fidelity simulator.