title: 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.
abstract: 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.
authors.affiliation: Department of Medicine I, University of Erlangen-Nürnberg, Erlangen, Germany. juergen.maiss@med1.imed.uni-erlangen.de
authors.forename: Juergen
authors.initials: J
authors.lastname: Maiss
authors.forename: Frederic
authors.initials: F
authors.lastname: Prat
authors.forename: Johannes
authors.initials: J
authors.lastname: Wiesnet
authors.forename: Andreas
authors.initials: A
authors.lastname: Proeschel
authors.forename: Kai
authors.initials: K
authors.lastname: Matthes
authors.forename: Andrea
authors.initials: A
authors.lastname: Peters
authors.forename: Eckhart G
authors.initials: EG
authors.lastname: Hahn
authors.forename: Denis
authors.initials: D
authors.lastname: Sautereau
authors.forename: Stanislas
authors.initials: S
authors.lastname: Chaussade
authors.forename: Juergen
authors.initials: J
authors.lastname: Hochberger
mesh_terms: 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