A novel training device for tip control in colonoscopy: preliminary validation and efficacy as a training tool

Riek, Stephan, Hill, Andrew, Plooy, Annaliese M., Horswill, Mark S., Cresp, Alanna St. G., Marinovic, Welber, Christofidis, Melany J., Burgess-Limerick, Robin, Wallis, Guy M., Watson, Marcus O. and Hewett, David G. (2017) A novel training device for tip control in colonoscopy: preliminary validation and efficacy as a training tool. Surgical Endoscopy, 31 12: 5364-5371. doi:10.1007/s00464-017-5617-7

Author Riek, Stephan
Hill, Andrew
Plooy, Annaliese M.
Horswill, Mark S.
Cresp, Alanna St. G.
Marinovic, Welber
Christofidis, Melany J.
Burgess-Limerick, Robin
Wallis, Guy M.
Watson, Marcus O.
Hewett, David G.
Title A novel training device for tip control in colonoscopy: preliminary validation and efficacy as a training tool
Journal name Surgical Endoscopy   Check publisher's open access policy
ISSN 0930-2794
Publication date 2017-12-01
Year available 2017
Sub-type Article (original research)
DOI 10.1007/s00464-017-5617-7
Open Access Status DOI
Volume 31
Issue 12
Start page 5364
End page 5371
Total pages 8
Place of publication New York, NY, United States
Publisher Springer New York LLC
Language eng
Abstract Effective control of the colonoscope tip is one of the most fundamental components of colonoscopy skill. Mastering fine tip control can be problematic for novice trainees, yet no validated training regimes exist for developing this specific skill component in isolation. We aimed to conduct a preliminary validation of a novel training device for colonoscopic tip control, and to assess its efficacy as a training tool.

In study 1 (validation), 13 experienced colonoscopists and 16 novices used a colonoscope to accurately track 28 targets on each of four concave "training surfaces" as quickly as possible, and we compared their performance. In study 2 (pre-post-training study), another 16 novices were tested before and after a six-session training program. In both studies, the main outcome measurements were completion time (measured automatically by the device) and variability of individual performance (the SD of each individual's completion times across trials).

Compared with novices, experienced colonoscopists were faster (P < 0.0001) and their performances less variable (P < 0.0001). With training, novices became faster (P < 0.0001) and more consistent (P = 0.003), and these improvements also generalized to novel training surfaces (P's < 0.01). After training, the novices' tip control performance was indistinguishable from that of the experienced colonoscopists (P's > 0.05). The composite measures of completion time used in both studies all had acceptable to excellent internal consistency reliability (α's ranged from 0.72 to 0.93).

We found that performance measures derived from using the device to assess skill can discriminate between experienced colonoscopists and novices in terms of their ability to control and guide the colonoscope tip precisely, providing preliminary evidence to support the construct validity of the metrics. The device is also an effective training tool for this fundamental component of colonoscopy skill.
Keyword Colonoscopy
Skill assessment
Tip control
Motor skill
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID FT100100020
Institutional Status UQ

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Created: Sat, 23 Dec 2017, 23:30:43 EST