Trainees can rapidly acquire ‘expert’ psychomotor skills necessary for endoscope tip control by using a virtual simulator, according to findings presented at DDW 2020.

A simulator-based training program with virtual coaches enabled most trainees to develop their own distinct one-hand endoscope tip control within four weeks, according to a presentation delivered via this year’s online DDW program.

The simulator, based on a model developed by researchers at Queensland University, consists of a hemispherical bowl with stickers labelled “A-Z” on its surface, which novices practice collecting with a standard colonoscope.

According to the Professor Roy Soetikno and colleagues from the University of California, San Francisco, many trainees currently spend a significant part of their first year developing their own endoscope tip control “style,” through a long self-discovery process because there is no standard training program.

“Their scope handling style can facilitate or hinder their endoscopy practice, particularly for complex cases,” they said.

They therefore assessed the impact of a simulator-based training program in 28 trainees with individualised feedback provided by virtual coaches in response to monitoring videos recorded on the trainees’ smartphones.

The trainees spent around 16 hours over four weeks completing 155 runs of simulated colonoscopy. By the end of the training all trainees acquired one-hand endoscope handling style and all but one reached the target speed of expert-level endoscopists, reducing the average time to complete an A to Z run from 169 to 72 seconds.

Most of the trainees 19/28 acquired all-finger technique and nine (32%) two-finger grip.

The investigators said the trainees rated the simulator training highly as a positive experience (4.5 out of 5) and felt that it was helpful for clinical practice.