TY - JOUR
T1 - Computer simulator among experts involved in screening colonoscopy
AU - Cantù, Paolo
AU - Grigolon, Ausilia
AU - Caparello, Chiara
AU - Bravi, Ivana
AU - Tenca, Andrea
AU - Elvevi, Alessandra
AU - Nicita, Maria Teresa
AU - Duca, Piergiorgio
AU - Conte, Dario
AU - Penagini, Roberto
PY - 2010/1
Y1 - 2010/1
N2 - Background: In the era of screening colonoscopy, assessment of operator competence is warranted. Aim: To evaluate feasibility of a computer simulator (CS) use for assessment of competence in colonoscopy by investigating performance of expert endoscopists at CS. Subjects: Twenty expert endoscopists involved in screening colonoscopy. Methods Experts returned a questionnaire regarding personal practice (duration of activity, number of colonoscopies in the last year and assistance by a nurse) and performances (percentage of caecal intubation and polyp detection rate). One easy and one difficult colonoscopy were proposed at CS in randomized order. Results Participation rate was 75%. Caecal intubation rate in clinical practice was more than 90% for all experts. At CS, time to caecal intubation and number of attempts for ileal intubation were significantly lower during easy versus difficult colonoscopy (P<0.01 for both items); interestingly, percentage of mucosa explored was higher (P<0.05) during the difficult simulation. Withdrawal time ≥ 6 min was achieved by 40 and 33% of experts during the easy and difficult simulation, respectively. Independent of simulation difficulty, time with loop was lower (P<0.05) for experts using hands-free insertion (n = 8) compared with those using nurse assistance in their clinical practice (n = 7). No correlation was found between scores at CS and performance in clinical practice. Conclusion: Scores at CS are sensitive to the rate of technical difficulty and nurse assistance during daily practice. Withdrawal time is often shorter than required for high accuracy in polyp detection. CS could be a well-accepted tool for assessment of competence.
AB - Background: In the era of screening colonoscopy, assessment of operator competence is warranted. Aim: To evaluate feasibility of a computer simulator (CS) use for assessment of competence in colonoscopy by investigating performance of expert endoscopists at CS. Subjects: Twenty expert endoscopists involved in screening colonoscopy. Methods Experts returned a questionnaire regarding personal practice (duration of activity, number of colonoscopies in the last year and assistance by a nurse) and performances (percentage of caecal intubation and polyp detection rate). One easy and one difficult colonoscopy were proposed at CS in randomized order. Results Participation rate was 75%. Caecal intubation rate in clinical practice was more than 90% for all experts. At CS, time to caecal intubation and number of attempts for ileal intubation were significantly lower during easy versus difficult colonoscopy (P<0.01 for both items); interestingly, percentage of mucosa explored was higher (P<0.05) during the difficult simulation. Withdrawal time ≥ 6 min was achieved by 40 and 33% of experts during the easy and difficult simulation, respectively. Independent of simulation difficulty, time with loop was lower (P<0.05) for experts using hands-free insertion (n = 8) compared with those using nurse assistance in their clinical practice (n = 7). No correlation was found between scores at CS and performance in clinical practice. Conclusion: Scores at CS are sensitive to the rate of technical difficulty and nurse assistance during daily practice. Withdrawal time is often shorter than required for high accuracy in polyp detection. CS could be a well-accepted tool for assessment of competence.
KW - Computer simulator
KW - Screening colonoscopy
KW - Virtual endoscopy
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U2 - 10.1097/MEG.0b013e32832ad615
DO - 10.1097/MEG.0b013e32832ad615
M3 - Article
C2 - 19680130
AN - SCOPUS:74349122820
VL - 22
SP - 61
EP - 66
JO - European Journal of Gastroenterology and Hepatology
JF - European Journal of Gastroenterology and Hepatology
SN - 0954-691X
IS - 1
ER -