Validation of a computer-based colonoscopy simulator.
BACKGROUND
The computer-based colonoscopy simulator is intended to provide a realistic colonoscopic experience and feedback to operators regarding procedure skills. Advocates hope that computer-based colonoscopy simulators will enhance the mastery of colonoscopy by trainees. Before this hypothesis can be tested, the claims made for a simulator must be validated. The aims of this study were to answer the following: Does a computer-based colonoscopy simulator provide a "realistic" experience? Do computer-based colonoscopy simulators' performance parameters differentiate varying levels of experience?


METHODS
Ten staff gastroenterologists, 6 gastroenterology fellows, and 6 residents each performed 2 computer-based colonoscopy simulator colonoscopies and performance parameters were recorded. Staff colonoscopists then completed a 6-item survey grading the "realism" of the simulation and procedure difficulty. Survey responses and performance scores were compared with the Wilcoxon rank-sum test.


RESULTS
Faculty found the computer-based colonoscopy simulator experience to be realistic despite the "cases" being markedly easier than actual colonoscopy. The computer-based colonoscopy simulator distinguishes subjects according to endoscopic experience with 3 of its measured parameters (total procedure time, insertion time, time in "red-out"). No significant difference in the ability to distinguish among user types was found for the other 10 computer-based colonoscopy simulator measurements for which data were analyzable.


CONCLUSIONS
The computer-based colonoscopy simulator provides a favorable degree of virtual realism with regard to visual simulation and colonoscope mechanics, although the "cases" were regarded as considerably easier than actual colonoscopy. The computer-based colonoscopy simulator has only limited capability for distinguishing varying levels of competence at actual colonoscopy. These findings suggest that a study to determine the role of computer-based colonoscopy simulators in the curriculum of trainees is warranted.
Sedlack
Robert E
RE
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
Kolars
Joseph C
JC
D002983:Clinical Competence; D003113:Colonoscopy / Q000379:methods*; D003198:Computer Simulation; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004502:Education, Medical, Continuing; D018961:Educational Technology; D005260:Female; D005762:Gastroenterology / Q000193:education / Q000379:methods; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital; D012680:Sensitivity and Specificity; D014584:User-Computer Interface