P1239 - Incorporation of Formal Simulator-Based Endoscopy Training Facilitates Sustained Improvement in Endoscopic Technical Ability

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Has Audio

Presenting Author(s)

AS

Abdullah S. Shaikh, MD

University of Texas MD Anderson Cancer Center
Houston, TX

Abdullah S. Shaikh, MD¹, Cyril B. Mazhuvanchery, MD¹, Ahmad Nakshabandi, MD², Daniel J. Low, MD¹, Gottumukkala S. Raju, MD¹, Mehnaz A. Shafi, MD², Selvi Thirumurthi, MD¹, Emmanuel Coronel, MD¹, Phillip Ge, MD¹
¹University of Texas MD Anderson Cancer Center, Houston, TX; ²UT MD Anderson Cancer Center, Houston, TX

Introduction: Endoscopic simulators have been demonstrated to improve endoscopic technical skills for gastroenterology trainees. However, the precise learning curves for the development of endoscopic technical skills in a simulator-enhanced fellowship training curriculum has not been previously reported or validated. Here, we present the experience and learning curves of two first-year adult gastroenterology fellows working with the Thompson Endoscopic Skills Trainer (TEST).

Methods: This was a longitudinal quality improvement initiative involving two first-year fellows at the ACGME-accredited University of Texas MD Anderson Cancer Center adult gastroenterology fellowship program, who incorporated the routine use of the TEST into their endoscopy training curriculum over the course of their fellowship training. The TEST has 5 exercises to develop and supplement the endoscopic skills of retroflexion, polypectomy, torque, scope tip control, and navigation and loop reduction. Each fellow completed 20 sessions over a 6 week period, which were scored based on the TEST instructions. Each exercise had 10 objectives worth 10 points each, and 5 minutes were given to complete all 10 objectives. Each extra second remaining would add 1 point to the score. Each fellow completed 1-3 sessions per day.

Results: After 20 sessions, each fellow’s total score on the TEST increased approximately 250% percent (Figure 1 & Table 1). As more sessions were completed by each fellow, overall scores increased and amount of time needed to complete the exercises also decreased, demonstrating improvement in endoscopic technical ability.

Discussion: Formal incorporation of endoscopic simulators such as the TEST facilitated sustained improvement in endoscopic skill over the course of the first year of gastroenterology fellowship. The results of this unique learning curve study support the role of endoscopic simulator-based training in allowing trainees to safely and effectively enhance their endoscopic technical ability in conjunction with traditional patient-centered endoscopy training. Ongoing studies will seek to further validate these findings throughout fellowship training and among additional trainees.

Figure: Line graph showing overall improvement in fellows' total scores on the Thompson Endoscopic Skills Trainer over time

		Session Number:	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20
Fellow	Exercise
1	Exercise 1: Polypectomy		10	8	8	6	5	9	6	9	10	10	8	10	8	10	10	10	10	10	10	10
1	Exercise 2: Retroflexion		2	3	4	4	5	5	5	6	4	6	7	9	10	8	9	7	8	9	8	6
1	Exercise 3: Torque		4	4	4	8	6	9	7	8	2	5	10	8	9	10	10	10	9	5	10	10
1	Exercise 4: Tip Deflection		3	5	3	5	7	4	8	7	9	7	6	8	10	9	9	10	10	10	10	9
1	Total Number of Seconds Left		40	0	0	0	0	0	0	0	90	100	22	53	17	101	65	119	145	65	254	210
1	Total Score		230	200	190	230	230	270	260	300	340	380	332	403	387	471	445	489	515	405	634	560

2	Exercise 1: Polypectomy		9	6	6	6	4	3	5	9	10	10	9	10	4	10	10	10	10	10	10	10
2	Exercise 2: Retroflexion		1	2	2	1	3	2	2	3	3	4	3	5	4	6	6	7	6	5	8	7
2	Exercise 3: Torque		1	2	2	4	3	2	5	4	4	4	5	5	6	6	7	6	6	5	7	7
2	Exercise 4: Tip Deflection		4	3	5	7	5	8	5	4	4	6	7	7	6	6	6	8	8	10	9	10
2	Total Number of Seconds Left		0	0	0	0	0	0	0	0	30	25	0	108	0	10	85	90	30	35	40	80
2	Total Score		150	130	150	180	150	150	170	200	240	265	240	378	200	290	375	400	330	335	380	420

Table: Thompson Endoscopic Skills Trainer individual exercise and total scores for each fellow

Disclosures:

Abdullah Shaikh indicated no relevant financial relationships.

Cyril Mazhuvanchery indicated no relevant financial relationships.

Ahmad Nakshabandi indicated no relevant financial relationships.

Daniel Low indicated no relevant financial relationships.

Gottumukkala Raju indicated no relevant financial relationships.

Mehnaz Shafi indicated no relevant financial relationships.

Selvi Thirumurthi indicated no relevant financial relationships.

Emmanuel Coronel indicated no relevant financial relationships.

Phillip Ge: Alira Health – Consultant. Boston Scientific – Consultant. Neptune Medical – Consultant. Ovesco America – Consultant.

Abdullah S. Shaikh, MD¹, Cyril B. Mazhuvanchery, MD¹, Ahmad Nakshabandi, MD², Daniel J. Low, MD¹, Gottumukkala S. Raju, MD¹, Mehnaz A. Shafi, MD², Selvi Thirumurthi, MD¹, Emmanuel Coronel, MD¹, Phillip Ge, MD¹. P1239 - Incorporation of Formal Simulator-Based Endoscopy Training Facilitates Sustained Improvement in Endoscopic Technical Ability, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.