Simulation-based mastery learning in gastrointestinal endoscopy training

Table 1 Development of endoscopy simulators

Ref.	Developer	Yr	Characteristics
Telleman et al[19], 2009	Erlangen-Nuremberg University Clinic	1974	An anatomical model of the esophagus, stomach, and duodenum used to train for endoscopic maneuvers
Williams et al[20], 2000	Imperial College/St Mark’s Hospital	1980	An anatomical model of the colon to train for angling maneuver in the organ
			Constant supervision is needed because trainees could damage the endoscope by excessive maneuvering
			The appearance of the colon surface is not realistic in the model
Classen and Ruppin[21], 1974	Imperial College/St Mark’s Hospital	1980	More realistic control compared to previous models as the endoscope can be rotated, and endoscope insertion and withdrawal can be detected
			Integrated with a monitor showing live simulation
			The length of the endoscope that can be inserted is limited
Williams et al[22], 1990	Imperial College/St Mark’s Hospital	1985	The endoscope can be fully inserted
			A sensation of resistance and an audio simulation that mimics patient’s complaints are included
			Still unrealistic
Long and Kalloo[15], 2006	Immersion Medical	2001	Provides an opportunity to practice various procedures, including biopsy
			Provides immediate feedback
			Realistic simulation as a sensation of resistance and contraction is included
Koch et al[23], 2008	Simbionix	2008	Provides realistic simulation
			Can be used to practice endoscopic maneuvers
			Can distinguish between the ability level of endoscopy experts and intermediate level
Triantafyllou[24], 2014	CAE Healthcare	2013	Can be accompanied by the patient’s history and various clinical parameters that can change during the endoscopy by the participant
			Combines endoscopic procedures with virtual backgrounds