title: A novel approach for augmenting percutaneous endoscopic gastrostomy tube placement training.
abstract: BACKGROUND
  Surgical trainees routinely participate in percutaneous endoscopic gastrostomy (PEG) tube placement. Although simulation has gained widespread acceptance, novice trainees continue learning this procedure on real patients. We designed a novel hands-on training model for practicing PEG tube placement with minimal monetary investment (cost<$10).
  
  
  METHODS
  Our portable low-fidelity bench model has a simulated upper gastrointestinal construct made of foam. Seventeen trainees used our model to acquire and practice skills necessary to perform PEG tube placement, for setting up and troubleshooting upper gastrointestinal endoscope, and for using endoscopic instruments in the state-of-the-art simulated operative room. Thirteen trainees completed the course evaluation, using a 5-point Likert scale (5=strongly agree).
  
  
  RESULTS
  The training resulted in a self-reported increase in equipment familiarity (4.23±0.73) and troubleshooting real endoscope (4.69±0.48), and trainees felt better prepared (4.23±0.93) for performing PEG tube placement on real patients. Trainees agreed that this exercise has more educational value than using virtual reality simulator alone (4.38±0.52).
  
  
  CONCLUSIONS
  Procedural training for PEG tube placement using a simple bench training model is perceived as valuable by trainees. Cost and commercial availability can be overcome by innovation in surgical simulation.
authors.affiliation: Department of Surgery Education, University of Pennsylvania Health System, Philadelphia, PA 19104, USA. drmkmittal@gmail.com
authors.forename: Mayank K
authors.initials: MK
authors.lastname: Mittal
authors.forename: Keith A
authors.initials: KA
authors.lastname: Kreitz
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Resnick
authors.forename: Jon B
authors.initials: JB
authors.lastname: Morris
authors.forename: Noel N
authors.initials: NN
authors.lastname: Williams
authors.forename: Kristoffel R
authors.initials: KR
authors.lastname: Dumon
mesh_terms: D004501:Education, Medical / Q000379:methods*; D004521:Educational Measurement; D004522:Educational Status; D005774:Gastrostomy / Q000193:education* / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008348:Manikins; D023421:Models, Animal; D017145:Models, Educational; D013337:Students, Medical; D013663:Teaching