Prediction of Endoscopic Skills on the Basis of General Unspecific Hand-Eye-Coordination Dexterity Test

Abstract

Introduction: The Erlangen Active Simulator for Interventional Endoscopy (EASIE) was presented in 1997 and up to now used in more than 150 national/international training courses. The objective benefit of compactEASIE training could be proved in two prospective randomized projects with New York and French Society for GI-Endoscopy (9/00-4/01 and 9/01-6/02 respectively). In this study, we want demonstrate if general hand-eye-coordination test (two hand coordinator (THC), wire ply test (WPT) are predictive for dexterity in GI-endoscopy and interventional hemostasis techniques Methods: Study design: prospective, randomized trial. training simulator: compactEASIE including upper GI-organ package and blood perfusion system. 32 Endoscopic novices (medical students, first year residents) were included. Initial evaluation of common dexterity (THC, WPT) basic endoscopic skills was done after an intensive practical and theoretical course in upper GI-endoscopy. Subsequently stratified randomisation due to the results of basic evaluation into intensive (n=19) and control group (n=13). Intensive group was trained for two hours courses over a period of 7 month 12 times every 2-3 weeks in 4 endoscopic disciplines (manual skills, injection therapy, hemoclip, band ligation) under supervision of skilled endoscopists (3 trainees/simulator). Assessment was performed (single steps/overall) by skilled tutors with analogous scale from 1-10 (1=worst, 10=best performance). 1/03 blinded final evaluation of all participants. Intermittent assessment was performed 3 times. Blinded final evaluation of all participants including common dexterity tests (THC, WPT) was done 1/03. Results: The results in common dexterity test of hand-eye coordination test showed no correlation with basic endoscopic skills or results in endoscopic hemostasis techniques at the beginning, during and at the end of the project. Conclusion: Basic common test of hand-eye-coordination seemed unsuitable to predict endoscopic skills or capabilities. Assessing the learning progress in basic endoscopic excercises appears to be more adequate to estimate the individual endoscopic talent.