Assessing the realism of colonoscopy simulation: The development of an instrument and systematic comparison of 4 simulators

Hill, Andrew, Horswill, Mark S., Plooy, Annaliese M., Watson, Marcus O., Karamatic, Rozemary, Basit, Tabinda A., Wallis, Guy M., Riek, Stephan, Burgess-Limerick, Robin and Hewett, David G. (2012) Assessing the realism of colonoscopy simulation: The development of an instrument and systematic comparison of 4 simulators. Gastrointestinal Endoscopy, 75 3: 631-640.


Author Hill, Andrew
Horswill, Mark S.
Plooy, Annaliese M.
Watson, Marcus O.
Karamatic, Rozemary
Basit, Tabinda A.
Wallis, Guy M.
Riek, Stephan
Burgess-Limerick, Robin
Hewett, David G.
Title Assessing the realism of colonoscopy simulation: The development of an instrument and systematic comparison of 4 simulators
Journal name Gastrointestinal Endoscopy  (ERA 2012 Listed)    (ERA 2010 Rank A)   Check publisher's open access policy
Publication date 2012-03
Sub-type Article
DOI 10.1016/j.gie.2011.10.030
Volume number 75
Issue number 3
ISSN 0016-5107; 1097-6779
Start page 631
End page 640
Total pages 10
Place of publication Philadelphia, PA, United States
Publisher Mosby
Collection year 2013
Language eng
Formatted abstract Background

No useful comparative data exist on the relative realism of commercially available devices for simulating colonoscopy.

Objectives

To develop an instrument for quantifying realism and provide the first wide-ranging empiric comparison.

Design

Repeated measures, observational study. Nineteen experienced colonoscopists completed cases on 4 colonoscopy simulators (AccuTouch, GI Mentor II, Koken, and Kyoto Kagaku) and evaluated each device.

Setting

A medical simulation center in a large tertiary hospital.

Main Outcome Measures

For each device, colonoscopists completed the newly developed Colonoscopy Simulator Realism Questionnaire (CSRQ), which contains 58 items grouped into 10 subscales measuring the realism of different aspects of the simulation. Subscale scores are weighted and combined into an aggregated score, and there is also a single overall realism item.

Results

Overall, current colonoscopy simulators were rated as only moderately realistic compared with real human colonoscopy (mean aggregated score, 56.28/100; range, 48.39–60.45, where 0 = “extremely unrealistic” and 100 = “extremely realistic”). On both overall realism measures, the GI Mentor II was rated significantly less realistic than the AccuTouch, Kyoto Kagaku, and Koken (P < .001). There were also significant differences between simulators on 9 subscales, and the pattern of results varied between subscales.

Limitations

The study was limited to commercially available simulators, excluding ex-vivo models. The CSRQ does not assess simulated therapeutic procedures.

Conclusions

The CSRQ is a useful instrument for quantifying simulator realism. There is no clear “first choice” simulator among those assessed. Each has unique strengths and weaknesses, reflected in the differing results observed across 9 subscales. These findings may facilitate the targeted selection of simulators for various aspects of colonoscopy training.
Keyword Endoscopy Simulator
Skills Assessment
Surgical Skills
Competence
Validation
Acquisition
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

 
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