Evaluation of a New Endoscopic Ultrasound (EUS) Simulator (EASIE-RTM) for Teaching Basic and Advanced Skills of EUS

Abstract

Purpose: EUS is a valuable diagnostic and therapeutic modality. Various types of EUS simulators have been used for teaching EUS. A novel model was recently developed, the modified Erlangen Active Simulator for Interventional Endoscopy (EASIE-RTM), with the capability of training physicians in diagnostic and therapeutic aspects of EUS. The aims of this study were to assess this instrument's visual realism and tissue pliability compared to humans, anatomical correlation to human anatomy, usefulness in teaching basic and advanced EUS skills, overall simulation realism, ease of use and ease of incorporation into fellowship training.Table: [1360] Mean, median, mode, interval, range, and percentage of attending give the mode and giving a score of 5 and above for each itemMethods: The study was designed as a prospective observational survey. 75 attending gastroenterologists participated in a 2-hour didactic session followed by a 2-hour hands-on training with the EASIE-RTM model at 1 of 5 centers. They had the opportunity to identify anatomical structures and perform fine needle aspiration (FNA) and pseudocyst drainage. Following completion of the hands-on session, they completed an evaluation form based on a 7-point Likert scale which included 9 questions assessing the instrument's visual realism and tissue pliability compared to humans, anatomical correlation to humans, usefulness in teaching basic and advanced EUS, overall simulation realism, usefulness as an educational tool, ease of use and ease of incorporation into fellowship programs. Results: Of the 75 gastroenterology attendings, 7/75 (9.33%) had no prior experience with EUS, 21/75 (28%) had 1-3 years, 16/75 (21.33%) had 4-10 years, and 4/75 (5.33%) had more than 10 years of EUS experience. No attending indicated having less than 1 year of EUS experience and 27/75 attendings (36%) did not indicate the number of years of EUS experience. A median score of 6 (agree) and a mode of 6 were obtained for most of the items (6/9, 66.67%). The lowest mode was a 5 (somewhat agree). The narrowest range of 3 (interval of 4-7) was obtained for the item assessing the usefulness of this model as an educational tool and its ease of use. A high percentage of participants gave a score of 5 and above for each item. Conclusion: It appears that the EASIE-RTM EUS Simulator may have potential as a useful educational/teaching tool for basic and advanced EUS skills as it appears to provide visual realism and tissue pliability compared to humans, has reasonable anatomical correlation to humans, is easy to use and easy to incorporate into fellowship training programs. Future studies are now needed that compare the performance of trainees who practice with the EASIE-RTM model prior to patient experience compared to a control group with no EASIE-RTM training to see whether their skills are significantly improved in the clinical setting. Disclosure: Dr Kai Matthes is the director of Endosim, LLC (Berlin, MA) and received material support from olympus America, Inc. The remainder of the authors disclosed no financial, professional, or personal relationships relevant to this study.