Simulation Training Clinical Trial
Official title:
Do Feedback Given by an Automatic and Objective System in Simulated Colonoscopy Increase Learning and Time Spent Practicing? A Randomized Trial
The aim is to investigate if feedback given by an automatic and objective system in simulated colonoscopy (the investigation of the large intestine) increase learning and time spent practicing.
A standardized Kagaku Colonoscopy Training Model (Kyoto Kagaku Co Ltd, Kyoto, Japan) in
combination with an Olympus colonoscope, a monitor and a Magnetic Endoscope Imaging (MEI)
Scope Guide (Olympus Medical systems Corp) is used. The Kyoto Kagaku Colonoscope Training
Model is a phantom model in full-size of the human colon. The model consists of an abdomen
model, a soft and flexible rubber colon, anal sphincter opening and an abdomen skin cover.
The rubber colon provides a realistic life-like response, which makes the participants able
to feel when the colonoscope stretch and bent the rubber colon. To reduce friction between
the rubber colon and the colonoscope a lubricant gels is applied inside the rubber colon. By
hand pump the anal sphincter is manipulated, allowing insufflation and suction. Six different
cases with different level of difficulty are possible. We chose case 2 (simple layout, but a
long sigmoid colon) and case 4 (a challenging layout, with a difficult-to-shorten sigmoid
colon and a drooping transverse colon) for training cases. Case 3 (simple layout, but with a
naturally formed "Alpha" loop in the sigmoid colon) is chosen for the final test.
Experts - 10 experts, defined by the number of colonoscopies in total (> 1000), colonoscopies
done within the last year (> 150) and locally considered among the best, will be recruited
voluntarily. The experts are introduced to the Colonoscopy Training Model and allowed 15
minutes of practices before tests is recorded. With the exception of the first expert who is
given the best Colonoscopy Progression Score (CoPS) executed by an instructor, the experts
are shown the other experts top scores for each case as a motivation. Each expert carries out
three different cases: Case 2, 3 and 4. Time for each case are 15 minutes.
Novices - 44 novices (interns and junior residents) with no experience in colonoscopy will be
enrolled through a volunteer application form in the study. All novices will be handed
written information about colonoscopy in general and basics. Novices will be introduced to
the technical characteristics of the colonoscope by an instructor and allowed training for 15
minutes before the data collection is started. No feedback (from instructors) will be given
during the training. Instructors will start data collection with introduction of the
colonoscope into the anus and the data collection is stopped when the cecum is reached. For
training the novices will have a free choice between case 2 and 4. Each novice is given the
opportunity to redo the training for as long as they like before they believe to be ready for
the final case. Case 3 will be used for the final test and all participants are to complete
the case tree times.
Novices will be randomized into two groups:
1. The intervention group is given feedback; presented with the CoPS after each time they
reach cecum. A leaderboard, presenting all the experts CoPS, for comparison and
motivation will be present next to the phantom model.
2. Control group is not given any CoPS.
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