Assessing the realism of colonoscopy simulation: the development of an instrument and systematic comparison of 4 simulators

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• 作者：Andrew Hill ; LLB(Hons) ; BA(Hons)¹ ; ⁴ ; Mark S. Horswill ; PhD¹ ; Annaliese M. Plooy ; PhD³ ; Marcus O. Watson ; PhD² ; ⁴ ; Rozemary Karamatic ; MBBS² ; ⁴ ; Tabinda A. Basit ; BA(Hons)¹ ; Guy M. Wallis ; PhD³ ; Stephan Riek ; PhD³ ; Robin Burgess-Limerick ; PhD³ ; David G. Hewett ; MBBS ; MSc ; PhD ; FRACP² ; ⁴ ;
• 关键词：ANOVA ; analysis of variance ; CSRQ ; Colonoscopy Simulator Realism Questionnaire ; CSRQ-IS ; Colonoscopy Simulator Realism Questionnaire&mdash ; Importance Supplement ; PM ; physical model ; VR ; virtual reality
• 刊名：Gastrointestinal Endoscopy
• 出版年：2012
• 出版时间：March 2012
• 年：2012
• 卷：75
• 期：3
• 页码：631-640.e3
• 全文大小：1708 K

文摘

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Background

No useful comparative data exist on the relative realism of commercially available devices for simulating colonoscopy.

Objectives

To develop an instrument for quantifying realism and provide the first wide-ranging empiric comparison.

Design

Repeated measures, observational study. Nineteen experienced colonoscopists completed cases on 4 colonoscopy simulators (AccuTouch, GI Mentor II, Koken, and Kyoto Kagaku) and evaluated each device.

Setting

A medical simulation center in a large tertiary hospital.

Main Outcome Measures

For each device, colonoscopists completed the newly developed Colonoscopy Simulator Realism Questionnaire (CSRQ), which contains 58 items grouped into 10 subscales measuring the realism of different aspects of the simulation. Subscale scores are weighted and combined into an aggregated score, and there is also a single overall realism item.

Results

Overall, current colonoscopy simulators were rated as only moderately realistic compared with real human colonoscopy (mean aggregated score, 56.28/100; range, 48.39-60.45, where 0 = ¡°extremely unrealistic?and 100 = ¡°extremely realistic?. On both overall realism measures, the GI Mentor II was rated significantly less realistic than the AccuTouch, Kyoto Kagaku, and Koken (P < .001). There were also significant differences between simulators on 9 subscales, and the pattern of results varied between subscales.

Limitations

The study was limited to commercially available simulators, excluding ex-vivo models. The CSRQ does not assess simulated therapeutic procedures.

Conclusions

The CSRQ is a useful instrument for quantifying simulator realism. There is no clear ¡°first choice?simulator among those assessed. Each has unique strengths and weaknesses, reflected in the differing results observed across 9 subscales. These findings may facilitate the targeted selection of simulators for various aspects of colonoscopy training.