Simulated training in colonoscopic stenting of colonic strictures: validation of a cadaver model

• Published in: Colorectal disease Vol. 17; no. 7; pp. 627 - 634
• Main Authors: Iordache, F., Bucobo, J. C., Devlin, D., You, K., Bergamaschi, R.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-07-2015
• Subjects: Adult; Cadaver; cadaver model; Clinical Competence; Colonic Diseases - surgery; colonic strictures; Colonoscopy; Colonoscopy - education; Colonoscopy - instrumentation; Colonoscopy - methods; Constriction, Pathologic - surgery; Female; Humans; Intestinal Obstruction - surgery; Male; Middle Aged; Models, Anatomic; Prospective Studies; Reproducibility of Results; Self Expandable Metallic Stents; simulated colonoscopy; Simulation Training - methods; stents; simulated colonoscopy; colonic strictures; cadaver model; Colonoscopy; stents
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/codi.12887

Aim
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.
Method
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).
Conclusion
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.