Validation of a novel swine model for training in EUS-FNA (with videos)

Li, Jun; Yao, Jun; Li, Shiyu; Wang, Shimin; Zhou, Wei; Jin, Zhendong; Wang, Kaixuan

doi:10.4103/eus.eus_13_20

Cited by 9 publications

(7 citation statements)

References 18 publications

(25 reference statements)

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“…Several publications have reported the advantages and limitations of each type of simulator [36][37][38][39][40][41][42][43][44][45][46][47][48][49], which are summarized in Table 1s, see online-only Supplementary material. Their value appears to be complementary, rather than being mutually exclusive, as each could be useful in achieving different and specific steps of EUS training.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

See 1 more Smart Citation

Curriculum for diagnostic endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Badaoui,

Teles de Campos,

Fusaroli

et al. 2023

Endoscopy

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Main RecommendationsThe European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in diagnostic endoscopic ultrasound (EUS). This manuscript represents the outcome of a formal Delphi process resulting in an official Position Statement of the ESGE and provides a framework to develop and maintain skills in diagnostic EUS. This curriculum is set out in terms of the prerequisites prior to training; the recommended steps of training to a defined syllabus; the quality of training; and how competence should be defined and evidenced before independent practice. 1 Trainees should have achieved competence in upper gastrointestinal endoscopy before training in diagnostic EUS. 2 The development of diagnostic EUS skills by methods that do not involve patients is advisable, but not mandatory, prior to commencing formal training in diagnostic EUS. 3 A trainee’s principal trainer should be performing adequate volumes of diagnostic EUSs to demonstrate maintenance of their own competence. 4 Training centers for diagnostic EUS should offer expertise, as well as a high volume of procedures per year, to ensure an optimal level of quality for training. Under these conditions, training centers should be able to provide trainees with a sufficient wealth of experience in diagnostic EUS for at least 12 months. 5 Trainees should engage in formal training and supplement this with a range of learning resources for diagnostic EUS, including EUS-guided fine-needle aspiration and biopsy (FNA/FNB). 6 EUS training should follow a structured syllabus to guide the learning program. 7 A minimum procedure volume should be offered to trainees during diagnostic EUS training to ensure that they have the opportunity to achieve competence in the technique. To evaluate competence in diagnostic EUS, trainees should have completed a minimum of 250 supervised EUS procedures: 80 for luminal tumors, 20 for subepithelial lesions, and 150 for pancreaticobiliary lesions. At least 75 EUS-FNA/FNBs should be performed, including mostly pancreaticobiliary lesions. 8 Competence assessment in diagnostic EUS should take into consideration not only technical skills, but also cognitive and integrative skills. A reliable valid assessment tool should be used regularly during diagnostic EUS training to track the acquisition of competence and to support trainee feedback. 9 A period of supervised practice should follow the start of independent activity. Supervision can be delivered either on site if other colleagues are already practicing EUS or by maintaining contacts with the training center and/or other EUS experts. 10 Key performance measures including the annual number of procedures, frequency of obtaining a diagnostic sample during EUS-FNA/FNB, and adverse events should be recorded within an electronic documentation system and evaluated.

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Section: Accepted Manuscriptmentioning

confidence: 99%

“…It is important that this knowledge base and practices developed from it are based on quality evidence. For EUS, simulators can be divided into the following categories [33][34][35][36][37][38]: phantoms, in vivo and ex vivo animal models, and computer-based/virtual reality (VR) simulators.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Curriculum for diagnostic endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Badaoui,

Teles de Campos,

Fusaroli

et al. 2023

Endoscopy

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show abstract

“…Other EUS simulators are animal models that have been used in the past for IEUS training; however, because of animal welfare concerns, few institutions worldwide still use them. The use of live animals for training requires specialized personnel, anesthesia, and ultimately sacrifice or euthanasia of the animals used 18,19 . Ex vivo simulators, which combine plastic materials with explanted animal organs, provide an alternative and more cost‐effective teaching tool, although the need for tissue replacement increases preparation time and costs and limits trainee access to instructional sessions 20 .…”

Section: Introductionmentioning

confidence: 99%

“…The use of live animals for training requires specialized personnel, anesthesia, and ultimately sacrifice or euthanasia of the animals used. 18,19 Ex vivo simulators, which combine plastic materials with explanted animal organs, provide an alternative and more cost-effective teaching tool, although the need for tissue replacement increases preparation time and costs and limits trainee access to instructional sessions. 20 Existing ex vivo therapeutic EUS simulators include the EUS Magic Box 21 F, the ENDOSIM EASIE-R4 model (EndoSim, LLC, Bolton, MA, USA), 22 and the mechanical phantom models for training therapeutic EUS and EUS-fine needle aspiration (FNA)/fine needle biopsy developed by Olympus (Olympus, Tokyo, Japan).…”

Section: Introductionmentioning

confidence: 99%

Impact and assessment of training models in interventional endoscopic ultrasound

Miutescu,

Dhir

2023

Digestive Endoscopy

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Interventional endoscopic ultrasound (IEUS) has gained significant popularity in recent years because of its diagnostic and therapeutic capabilities. The proper training of endoscopists is critical to ensure safe and effective procedures. This review study aims to assess the impact of different training models on the competence of trainees performing IEUS. Eight studies that evaluated simulators for IEUS were identified in the medical literature. Various training models have been used, including the EASIE‐R, Mumbai EUS, EUS Magic Box, EndoSim, Thai Association for Gastrointestinal Endoscopy model, and an ex vivo porcine model (HiFi SAM). The trainees underwent traditional didactic lectures, hands‐on training using simulators, and direct supervision by experienced endoscopists. The effectiveness of these models has been evaluated based on objective and subjective parameters such as technical proficiency, operative time, diagnostic success, and participant feedback. As expected, the majority of skills were improved after the training sessions concluded, although the risk of bias is high in the absence of external validation. It is difficult to determine the ideal simulator among the existing ones because of the wide variation between them in terms of costs, reusability, design, fidelity of anatomical structures and feedback, and types of procedures performed. There is a need for a standardized approach for the evaluation of IEUS simulators and the ways skills are acquired by trainees, as well as a clearer definition of the key personal attributes necessary for developing a physician into a skilled endoscopist capable of performing basic and advanced therapeutic EUS interventions.

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“…Some centers have tried to develop phantom models for the purpose of training intervention procedures. [ 13 14 15 ] The performance of interventional EUS procedures requires high skill and expertise. As they carry potential risks, nonhuman models might be the best training tool at this moment.…”

mentioning

confidence: 99%

Learning in therapeutic EUS

Giovannini

2021

Endosc Ultrasound

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Validation of a novel swine model for training in EUS-FNA (with videos)

Cited by 9 publications

References 18 publications

Curriculum for diagnostic endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Curriculum for diagnostic endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Impact and assessment of training models in interventional endoscopic ultrasound

Learning in therapeutic EUS

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