Expert benchmark for the GI Mentor II.
BACKGROUND
There is increasing interest in the use of virtual-reality simulators in general surgery residency training. Many simulators lack a benchmark against which trainees can measure competence and skill.


METHODS
Surgeons who had performed over 1,000 colonoscopies were evaluated on module 1, case 5 of the GI Mentor I or II virtual-reality endoscopy simulator (Simbionix, Cleveland). Participants were given 5 min to familiarize themselves with the simulator, and then performed the study case with standardized instructions. Metrics were recorded by using the previously calibrated simulator.


RESULTS
Twenty-three surgeons (21 male, 2 female) participated. Mean height was 69.6 +/- 2.6 inches, mean age 51 +/- 9 years, median surgical glove size 7.5, and surgeons had 18.8 +/- 10.1 years of practice, and did 8 +/- 6 colonoscopies weekly. Ten participants had advanced training in endoscopy, laparoscopy or colorectal surgery; eight had used the simulator before, of whom six had used it once. Mean time to complete the study case was 13.6 +/- 5.3 min and time to reach the cecum was 6.5 +/- 4.3 min. Participants examined 92.3 +/- 3.6% of the simulated colonic mucosa with a clear view of the lumen 89.5 +/- 4.2% of the time. Total time the colon was looped was 22 +/- 35 s (range 0-133 s). The overall efficiency of screening was 70.33 +/- 23.45% (range 20-94%). Participants tended to mistake normal simulated colonic structures as pathology.


CONCLUSIONS
Performance on a virtual-reality endoscopic simulator has a wide amount of variability even among a group of experienced endoscopists. Expert benchmark tests should be performed on simulators that will be used for resident assessment prior to any attempts at certification of competence.
Phitayakorn
Roy
R
Department of Surgery, University Hospitals Case Medical Center, Cleveland, OH 44106-5047, USA. ropst14@hotmail.com
Marks
Jeffrey M
JM
Reynolds
Harry L
HL
Delaney
Conor P
CP
D000328:Adult; D000368:Aged; D019985:Benchmarking; D002983:Clinical Competence; D003113:Colonoscopy / Q000379:methods*; D003198:Computer Simulation; D004724:Endoscopy / Q000193:education*; D004867:Equipment Design; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014584:User-Computer Interface