TY - JOUR
T1 - Democratizing Flexible Endoscopy Training: Noninferiority Randomized Trial Comparing a Box-Trainer vs a Virtual Reality Simulator to Prepare for the Fundamental of Endoscopic Surgery Exam
AU - Mascagni, Pietro
AU - Spota, Andrea
AU - Pizzicannella, Margherita
AU - Laracca, Giovanni Guglielmo
AU - Svendrovski, Anton
AU - Fiorillo, Claudio
AU - Lim, Sun Gyo
AU - Oudkerk Pool, Marinka
AU - Dallemagne, Bernard
AU - Marescaux, Jacques
AU - Swanstrom, Lee
AU - Shlomovitz, Eran
AU - Perretta, Silvana
PY - 2022
Y1 - 2022
N2 - BACKGROUND: A considerable number of surgical residents fail the mandated endoscopy exam despite having completed the required clinical cases. Low-cost endoscopy box trainers (BTs) could democratize training; however, their effectiveness has never been compared with higher-cost virtual reality simulators (VRSs).STUDY DESIGN: In this randomized noninferiority trial, endoscopy novices trained either on the VRS used in the Fundamental of Endoscopic Surgery manual skills (FESms) exam or a validated BT-the Basic Endoscopic Skills Training (BEST) box. Trainees were tested at fixed timepoints on the FESms and on standardized ex vivo models. The primary endpoint was FESms improvement at 1 week. Secondary endpoints were FESms improvement at 2 weeks, FESms pass rates, ex vivo tests performance, and trainees' feedback.RESULTS: Seventy-seven trainees completed the study. VRS and BT trainees showed comparable FESms improvements (25.16 +/- 14.29 vs 25.58 +/- 11.75 FESms points, respectively; p = 0.89), FESms pass rates (76.32% vs 61.54%, respectively; p = 0.16) and total ex vivo tasks completion times (365.76 +/- 237.56 vs 322.68 +/- 186.04 seconds, respectively; p = 0.55) after 1 week. Performances were comparable also after 2 weeks of training, but FESms pass rates increased significantly only in the first week. Trainees were significantly more satisfied with the BT platform (3.97 +/- 1.20 vs 4.81 +/- 0.40 points on a 5-point Likert scale for the VRS and the BT, respectively; p < 0.001).CONCLUSIONS: Simulation-based training is an effective means to develop competency in endoscopy, especially at the beginning of the learning curve. Low-cost BTs like the BEST box compare well with high-tech VRSs and could help democratize endoscopy training. (C) 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.
AB - BACKGROUND: A considerable number of surgical residents fail the mandated endoscopy exam despite having completed the required clinical cases. Low-cost endoscopy box trainers (BTs) could democratize training; however, their effectiveness has never been compared with higher-cost virtual reality simulators (VRSs).STUDY DESIGN: In this randomized noninferiority trial, endoscopy novices trained either on the VRS used in the Fundamental of Endoscopic Surgery manual skills (FESms) exam or a validated BT-the Basic Endoscopic Skills Training (BEST) box. Trainees were tested at fixed timepoints on the FESms and on standardized ex vivo models. The primary endpoint was FESms improvement at 1 week. Secondary endpoints were FESms improvement at 2 weeks, FESms pass rates, ex vivo tests performance, and trainees' feedback.RESULTS: Seventy-seven trainees completed the study. VRS and BT trainees showed comparable FESms improvements (25.16 +/- 14.29 vs 25.58 +/- 11.75 FESms points, respectively; p = 0.89), FESms pass rates (76.32% vs 61.54%, respectively; p = 0.16) and total ex vivo tasks completion times (365.76 +/- 237.56 vs 322.68 +/- 186.04 seconds, respectively; p = 0.55) after 1 week. Performances were comparable also after 2 weeks of training, but FESms pass rates increased significantly only in the first week. Trainees were significantly more satisfied with the BT platform (3.97 +/- 1.20 vs 4.81 +/- 0.40 points on a 5-point Likert scale for the VRS and the BT, respectively; p < 0.001).CONCLUSIONS: Simulation-based training is an effective means to develop competency in endoscopy, especially at the beginning of the learning curve. Low-cost BTs like the BEST box compare well with high-tech VRSs and could help democratize endoscopy training. (C) 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.
KW - inglese
KW - inglese
UR - http://hdl.handle.net/10807/260342
U2 - 10.1097/XCS.0000000000000157
DO - 10.1097/XCS.0000000000000157
M3 - Article
SN - 1072-7515
VL - 234
SP - 1201
EP - 1210
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
ER -