The complementary Erlangen active simulator for interventional endoscopy training is superior to solely clinical education in endoscopic hemostasis--the French training project: a prospective trial.
BACKGROUND
The Erlangen Active Simulator for Interventional Endoscopy (EASIE) using ex-vivo porcine organs was introduced in 1997. The present study should analyze whether repeated EASIE simulator training in endoscopic hemostasis led to superior performance compared with a traditionally educated group. The results were compared with a similar project in New York.


METHODS
Thirty-five French GI fellows were enrolled. Baseline skills evaluation was performed in four disciplines (manual skills, injection/coagulation, clip application and variceal ligation) using the compactEASIE-simulator equipped with an upper gastrointestinal organ package for bleeding simulation. The same, translated evaluation forms (from the prior New York project) were used. Subsequently, fellows were randomized into group A (n=17, only clinical education) and group B (n=18, additional three simulator trainings). Group B was trained the next day and after 4 and 7 months by experts of the French Society of Gastrointestinal Endoscopy. Both groups performed routine and emergency endoscopies at their home hospitals during the study period. Both groups were re-evaluated blindly after 9 months.


RESULTS
The learning curve for group B showed a significant improvement in all disciplines (P<0.004) whereas group A improved significantly in only two of four disciplines at blinded final evaluation (manual skills P=0.02, injection/coagulation P=0.013). The direct comparison of groups B and A at blinded final evaluation showed significantly superior ratings for group B in all disciplines (P<0.006) and significantly shorter performance times in two disciplines (P=0.016 each). The comparison with the similar 'New York project' revealed that preexisting differences in skills were adjusted by the training.


CONCLUSIONS
Complementary trainings (three workshops in 7 months) in endoscopic hemostasis using the compactEASIE improved skills compared with a solely clinical education. The results of the 'New York project' were confirmed and benefits were independent from the medical educational system.
Maiss
Juergen
J
Department of Medicine I, University of Erlangen-Nürnberg, Erlangen, Germany. juergen.maiss@med1.imed.uni-erlangen.de
Prat
Frederic
F
Wiesnet
Johannes
J
Proeschel
Andreas
A
Matthes
Kai
K
Peters
Andrea
A
Hahn
Eckhart G
EG
Sautereau
Denis
D
Chaussade
Stanislas
S
Hochberger
Juergen
J
D000818:Animals; D002983:Clinical Competence; D003194:Computer-Assisted Instruction / Q000379:methods*; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005602:France; D016558:Hemostasis, Endoscopic / Q000193:education*; D006801:Humans; D023421:Models, Animal; D011446:Prospective Studies; D013552:Swine; D014481:United States