title: Simulated training in colonoscopic stenting of colonic strictures: validation of a cadaver model.
abstract: OBJECTIVE
  There are currently no available simulation models for training in colonoscopic stent deployment. The aim of this study was to validate a cadaver model for simulation training in colonoscopy with stent deployment for colonic strictures.
  
  
  METHODS
  This was a prospective study enrolling surgeons at a single institution. Participants performed colonoscopic stenting on a cadaver model. Their performance was assessed by two independent observers. Measurements were performed for quantitative analysis (time to identify stenosis, time for deployment, accuracy) and a weighted score was devised for assessment. The Mann-Whitney U-test and Student's t-test were used for nonparametric and parametric data, respectively. Cohen's kappa coefficient was used for reliability.
  
  
  RESULTS
  Twenty participants performed a colonoscopy with deployment of a self-expandable metallic stent in two cadavers (groups A and B) with 20 strictures overall. The median time was 206 s. The model was able to differentiate between experts and novices (P = 0. 013). The results showed a good consensus estimate of reliability, with kappa = 0.571 (P < 0.0001).
  
  
  CONCLUSIONS
  The cadaver model described in this study has content, construct and concurrent validity for simulation training in colonoscopic deployment of self-expandable stents for colonic strictures. Further studies are needed to evaluate the predictive validity of this model in terms of skill transfer to clinical practice.
authors.affiliation: Division of Colon and Rectal Surgery, State University of New York, Stony Brook, New York, USA.
authors.forename: F
authors.initials: F
authors.lastname: Iordache
authors.affiliation: Division Gastroenterology, State University of New York, Stony Brook, New York, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Bucobo
authors.affiliation: Division of Colon and Rectal Surgery, State University of New York, Stony Brook, New York, USA.
authors.forename: D
authors.initials: D
authors.lastname: Devlin
authors.affiliation: Division of Colon and Rectal Surgery, State University of New York, Stony Brook, New York, USA.
authors.forename: K
authors.initials: K
authors.lastname: You
authors.affiliation: Division of Colon and Rectal Surgery, State University of New York, Stony Brook, New York, USA.
authors.forename: R
authors.identifier: http://orcid.org/0000-0001-9993-0563
authors.initials: R
authors.lastname: Bergamaschi
mesh_terms: D000328:Adult; D002102:Cadaver; D002983:Clinical Competence; D003108:Colonic Diseases / Q000601:surgery*; D003113:Colonoscopy / Q000193:education* / Q000295:instrumentation / Q000379:methods; D003251:Constriction, Pathologic / Q000601:surgery; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D011446:Prospective Studies; D015203:Reproducibility of Results; D000069322:Self Expandable Metallic Stents; D000066908:Simulation Training / Q000379:methods*
keywords: Colonoscopy; cadaver model; colonic strictures; simulated colonoscopy; stents