title: Simulation-based training for colonoscopy: establishing criteria for competency.
abstract: The aim of this study was to create simulation-based tests with credible pass/fail standards for 2 different fidelities of colonoscopy models. Only competent practitioners should perform colonoscopy. Reliable and valid simulation-based tests could be used to establish basic competency in colonoscopy before practicing on patients. Twenty-five physicians (10 consultants with endoscopic experience and 15 fellows with very little endoscopic experience) were tested on 2 different simulator models: a virtual-reality simulator and a physical model. Tests were repeated twice on each simulator model. Metrics with discriminatory ability were identified for both modalities and reliability was determined. The contrasting-groups method was used to create pass/fail standards and the consequences of these were explored. The consultants significantly performed faster and scored higher than the fellows on both the models (P < 0.001). Reliability analysis showed Cronbach α = 0.80 and 0.87 for the virtual-reality and the physical model, respectively. The established pass/fail standards failed one of the consultants (virtual-reality simulator) and allowed one fellow to pass (physical model). The 2 tested simulations-based modalities provided reliable and valid assessments of competence in colonoscopy and credible pass/fail standards were established for both the tests. We propose to use these standards in simulation-based training programs before proceeding to supervised training on patients.
authors: From the Department of Surgical Gastroenterology and transplantation, Rigshospitalet, and Copenhagen University (LP,LBS), Centre for Clinical Education (CEKU) and Copenhagen University (MBSS,LK), Department of Surgical Gastroenterology, University hospital of Herlev (NN), Copenhagen University Hospital, Herlev, The Capital Region of Denmark.
authors: Louise
authors: L
authors: Preisler
authors: Morten Bo Søndergaard
authors: MBS
authors: Svendsen
authors: Nikolaj
authors: N
authors: Nerup
authors: Lars Bo
authors: LB
authors: Svendsen
authors: Lars
authors: L
authors: Konge
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003113:Colonoscopy / Q000193:education*; D003194:Computer-Assisted Instruction; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D008348:Manikins; D008875:Middle Aged; D011446:Prospective Studies
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