Impact of a simulation-based induction programme in gastroscopy on trainee outcomes and learning curves

Table 2 Comparisons of module-dependent EndoSim metrics between trainees (stratified into novice and intermediate experience groups) and faculty members

Module	Metric	Median (IQR)		P value (Expert vs trainee)	Median (IQR)		P value (Novice vs intermediate)
		Expert (n =6)	Trainee (n = 20)		Novice trainee (n = 10)	Intermediate trainee (n = 10)
Module 1: Wheel Handling (4 stations)	Missed targets	3 (1-4)	6 (3-8)	< 0.001	7 (4-9)	6 (2-8)	0.057
	Wheel rotation left/right (Degrees)	257 (42-382)	143 (5-591)	0.463	82 (1-643)	166 (9-575)	0.753
	Wheel rotation up/down (Degrees)	783 (691-916)	764 (606-1173)	0.903	680 (442-1005)	1023 (687-1303)	0.003
	Endoscope rotation (Degrees)	1398 (749-2355)	964 (353-1577)	0.025	886 (350-1404)	1044 (349-1955)	0.350
Module 2: Navigation (3 stations)	Total time (s)	74 (52-104)	104 (79-166)	0.002	161 (108-218)	82 (67-105)	< 0.001
	Wheel rotation left/right (Degrees)	109 (40-305)	138 (3-757)	0.826	391 (3-1648)	99 (2-549)	0.143
	Wheel rotation up/down (Degrees)	888 (680-1108)	1232 (934-1868)	0.001	1268 (958-1737)	1224 (931-2046)	0.641
	Endoscope rotation (Degrees)	1120 (933-1865)	1770 (1313-2334)	0.007	1847 (1258-2571)	1722 (1357-2258)	0.503
	Endoscope tip path length (cm)	228 (179-306)	324 (251-411)	0.002	357 (280-489)	280 (239-356)	0.028
Module 3: Button Handling (3 stations)	Missed targets (number)	2 (0-4)	2 (1-4)	0.623	2 (1-5)	1.5 (1-4)	0.805
	Unnecessary button presses (number)	2 (0-4)	2 (1-4)	0.270	2 (1-5)	2 (1-4)	0.963
	Missed dirt (number)	1 (1-2)	1 (1-2)	0.944	1 (0-2)	1 (1-2)	0.429
Module 4: Photo (4 stations)	Total time (s)	151 (121-192)	313 (230-377)	< 0.001	328 (235-404)	269 (179-361)	0.054
	Stomach visualized (%)	93% (79%-99%)	100 (96%-100%)	< 0.001	99% (94%-100%)	100% (97%-100%)	0.070
	Duodenum visualized (%)	63% (52%-74%)	63% (53-72%)	0.855	62% (51%-68%)	66% (58%-74%)	0.088
	Collisions against mucosa (number)	8 (5-12)	13 (9-16)	< 0.001	13 (11-20)	12 (8-15)	0.090
	Targets photographed (%)	100% (100%-100%)	100% (100%-100%)	0.495	100% (100%-100%)	100% (100%-100%)	0.302
Module 5: Biopsy (3 stations)	Total time (s)	182 (163-217)	340 (249-463)	< 0.001	446 (331-522)	299 (215-389)	0.001
	Targets biopsied	100% (100%-100%)	100% (50-100%)	0.010	100% (38%-100%)	100% (50%-100%)	0.546
	Biopsies outside any target (number)	0 (0-2)	4 (2-9)	< 0.001	3 (2-8)	4 (2-11)	0.548
	Collisions against mucosa (number)	7 (4-11)	9 (7-13)	0.030	12 (9-23)	7 (6-11)	< 0.001
	Movement with tool (cm)	25 (17-53)	72 (36-183)	0.002	73 (29-183)	70 (42-179)	0.910

Data are presented as medians (interquartile ranges), with P values derived from Mann-Whitney tests. Bold P values are significant at P < 0.05. IQR: Interquartile ranges.