Evaluation of Feedback Enabled Active Colonoscopy Training Model

Abstract

The objective of this research is to evaluate the efficacy of an active colonoscopy training model (ACTM). Colonoscopy is a widely utilized procedure for diagnosing diseases of the lower gastrointestinal tract. Since colonoscopy is a difficult procedure to teach, as well as learn, simulators are often used to teach and practice the procedure. To make learning and assessing the procedural skills easy and interactive, an active training model was developed and evaluated. To measure the applied force and the time to complete the procedure, load cells and light detecting sensors were installed in the training model and were interfaced with a data acquisition system. The user interface was programmed in LabVIEW to record the force data and time taken to complete the procedure. Thirty medical students were recruited to perform a series of three colonoscopies on the ACTM. These students were instructed how to handle the equipment and perform the colonoscopy. The procedure was also performed by experienced endoscopists to establish a benchmark. The collected data were analyzed to determine the effectiveness of the device to (1) distinguish between the participants based on their level of expertise, and (2) to detect improvement in skill of the students with repetitive sessions with the device. The results of this research may be useful to show that the ACTM may be an effective tool to integrate in to the medical training program of medical studies. It can be possibly used for evaluating the skill sets, as well as practicing the procedure before a novice surgeon performs the procedure on a patient.

Colonoscopy competence assessment tools: a systematic review of validity evidence

“…Only one tool included normative data in addition to easily interpretable scores. [42,43] Eight tools required no additional resources beyond the tool itself and involved less than one hour of assessor training [20][21][22][23][29][30][31][33][34][35][36][37][38][39][40][42][43][44][45][46], while five tools required more intensive assessor training.…”

“…[40] Seven studies were conducted in single institutions [20,[40][41][42][43][44][45], two in two institutions [25,32], and fifteen in more than two institutions [22][23][24][26][27][28][29][30][31][34][35][36]38,39,46]. Twenty-three studies provided objective data from external assessors [21][22][23][24][25][26][27][28][29][30][31][32][34][35][36][38][39][40][41][42][43]45,46], and one study provided data generated by the individuals being assessed. [44] All studies provided more than just descriptive statistics and had appropriate data analysis methods.…”

“…presented assessment data in the clinical setting [21][22][23][24][25][26][27][28][29][30][31][32][34][35][36][38][39][40][41]45,46,44], while two studies provided assessment data in the simulated setting. [42,43] No studies provided data on patient or healthcare-related outcomes.…”

“…Compared to previous reviews, our broad search strategy included conference abstracts and recent literature, incorporating one additional tool [45] and new validity evidence for existing tools. [27,35] Studies which evaluated tools for pediatric colonoscopy [28,38] and simulated colonoscopy [42,43] were also included. This review also has important limitations.…”

A Hand-Held Device for Controlling a Mounted, Motor Driven Colonoscope1

“…was observed through two values: cecal intubation time and learning rate. These values were measured and compared between the two scopes as medical students performed multiple procedures on the Active Colonoscopy Training Model (a colon simulator) as seen in Figure 37[30]. Cecal intubation rate was considered as the duration from insertion of the scope into the simulated colon to reaching the end of the colon (cecum).…”