Computer colonoscopy simulators were introduced a little more han a decade ago with a great amount of hype and hope as to hat they could accomplish. As a result of research efforts, it is ow generally accepted that these simulators do indeed have an mpact as a training tool, although limited to the initial stages of olonoscopy training. Educators however, have had far less luck n demonstrating any usefulness of these commercially available imulators as assessment tools. It is not mutually inclusive that a useful teaching tool is necssarily a useful assessment tool. This holds true for colonoscopy omputer simulators as well. The use of these devices has been hown to accelerate the acquisition of certain endoscopic skills esulting in greater caecal intubation rates, superior haemostasis esults, and greater patient comfort [1,2]. These effects however re generally limited to the first 20–50 procedures and any benet beyond this range has yet to be shown. These limited training enefits are likely the result of the reasonable haptic and visual ealism they provide allowing for the transfer of some rudimentary ands-on skills. However, the fidelity of the simulation scenarios is empered by the excessive ease of the cases currently available. In contrast, the ability of these simulators to be used in assessng skills relies very little on the simulation realism but instead on he accuracy of the computer measured metrics of skill. These metics examine factors such as the degree of scope looping, amount f air used, time to reach the caecum, time spent in “red-out” gainst the wall, and even a metric of patient discomfort during the imulated procedure. A number of studies have been done to “valdate” these simulators [1,3]. While most simulators have shown ome degree of simulation realism, none have found the computer easured metrics of skill to be able to meaningfully discriminate etween users based on level of experience except for a few time elated metrics, and only between users of markedly different skill evel. The article by Elvevi et al. in the current issue of Digestive nd Liver Disease specifically examines the assessment abilities of computer simulator with similar results [4]. In this study, the uthors examine the performance metrics generated by the GI entor colonoscopy simulator (Simbionix Ltd., Lod, Israel) durng procedures completed by trainees at two stages of training
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May 28, 2012
A M Verma + 7
Open Access
