Abstract

Abstract Background Polypectomy is an essential endoscopic skill involving the removal of potentially premalignant lesions during colonoscopy. The ad hoc nature of polyp encounters is a significant barrier to polypectomy training, as this limits the ability to deliberately practice the skill. Effective and accessible polypectomy simulators may improve global implementation of polypectomy curricula. Aims To determine the face and content validity of a novel low-cost gel polyp simulator for use in endoscopic training programs. Methods A novel gel polyp simulator with multiple polyp morphologies based on the Paris classification was developed and used with a commercially available colonic phantom (Koken Lower GI Endoscopy Simulator Type II LM-107, Koken CO.LTD, Japan) in an endoscopy simulation-based training course (July, 2023). Feedback based on previous prototypes of the simulator were implemented into the simulator utilized in the present study. Novice (ampersand:003C25 procedures) and expert (ampersand:003E1000 procedures) endoscopists performed simulated procedures with the gel polyps. Using a five-point Likert scale (“strongly agree” to “strongly disagree”), a post-training survey based on previously published surveys used to determine the face and content validity of low-cost physical colonic simulators was administered. A section for additional comments was placed at the end of the survey. Results The face and content validity survey was completed by 3 experts and 21 novices. The median score for all face validity questions was 5 (IQR 5-5) from experts and 5 (IQR 5-5) from novices. The median score for all content validity questions was 5 (IQR 5-4) from experts and 5 (IQR 5-5) from novices. In the additional comments section of the survey, one expert commented that future iterations of the gel polyps should be made thicker so that trainees could practice using endoscopic clips. The gel polyp simulator cost $0.61 CAD/polyp including the cost of materials and 3D printed molds. Conclusions The gel polyp simulator appears to be a feasible modality for polypectomy training that is reproducible using accessible and low cost materials. Face and Content Validity Survey (questions and median survey score) Funding Agencies None

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