Multicenter, randomized, controlled trial of virtual-reality simulator training in acquisition of competency in colonoscopy.
BACKGROUND
The GI Mentor is a virtual reality simulator that uses force feedback technology to create a realistic training experience.


OBJECTIVE
To define the benefit of training on the GI Mentor on competency acquisition in colonoscopy.


METHODS
Randomized, controlled, blinded, multicenter trial.


METHODS
Academic medical centers with accredited gastroenterology training programs.


METHODS
First-year GI fellows.


METHODS
Subjects were randomized to receive 10 hours of unsupervised training on the GI Mentor or no simulator experience during the first 8 weeks of fellowship. After this period, both groups began performing real colonoscopies. The first 200 colonoscopies performed by each fellow were graded by proctors to measure technical and cognitive success, and patient comfort level during the procedure.


METHODS
A mixed-effects model comparison between the 2 groups of objective and subjective competency scores and patient discomfort in the performance of real colonoscopies over time.


RESULTS
Forty-five fellows were randomized from 16 hospitals over 2 years. Fellows in the simulator group had significantly higher objective competency rates during the first 100 cases. A mixed-effects model demonstrated a higher objective competence overall in the simulator group (P < .0001), with the difference between groups being significantly greater during the first 80 cases performed. The median number of cases needed to reach 90% competency was 160 in both groups. The patient comfort level was similar.


CONCLUSIONS
Fellows who underwent GI Mentor training performed significantly better during the early phase of real colonoscopy training.
Cohen
Jonathan
J
NYU School of Medicine, New York, NY, USA.
Cohen
Seth A
SA
Vora
Kinjal C
KC
Xue
Xiaonan
X
Burdick
J Steven
JS
Bank
Simmy
S
Bini
Edmund J
EJ
Bodenheimer
Henry
H
Cerulli
Maurice
M
Gerdes
Hans
H
Greenwald
David
D
Gress
Frank
F
Grosman
Irwin
I
Hawes
Robert
R
Mullin
Gerard
G
Mullen
Gerard
G
Schnoll-Sussman
Felice
F
Starpoli
Anthony
A
Stevens
Peter
P
Tenner
Scott
S
Villanueva
Gerald
G
D002983:Clinical Competence; D003113:Colonoscopy / Q000379:methods*; D003198:Computer Simulation; D004724:Endoscopy / Q000193:education*; D005257:Fellowships and Scholarships; D005762:Gastroenterology / Q000193:education*; D006801:Humans; D017060:Patient Satisfaction; D014584:User-Computer Interface