Virtual reality tools for training in gastrointestinal endoscopy: A systematic review

Table 2 Training methods, evaluation, comparator and outcomes of studies included in this systematic review of virtual reality training in gastrointestinal endoscopy

Ref.	Training methods	Duration of training and frequency of training sessions	Self-evaluation methods	Evaluation by trainers	Comparator	Main outcomes measured
Buzink et al[4], 2007	Basic skills training	4 sessions, each session: One EndoBubble task and managed multiple VR colonoscopy cases (two in first session and three in subsequent sessions)		Objective metrics		Proecess skills, procedure time
Cohen et al[15], 2006	Basic skills training	10 h of unsupervised training on the GI Mentor or no simulator experience during the first 8 wk of fellowship		Expert evaluations	No intervention	Procedure completion, global rating of performance, patient discomfort
Ferlitsch et al[10], 2002	Basic skills training	2 h per d, 3 wk		Objective metrics	No intervention	Proecess skills, procedure time
Ferlitsch et al[12], 2010	Basic skills training	2 h per d, 5 h to 20 h in total		Expert evaluations	Conventional, patient-based training only	Precedure time, patient discomfort
Gerson and Van Dam[19], 2003	Basic skills training	2 wk or ten sigmoidoscopy examination with attending gastroenterologists		Expert evaluations	Bedside teaching	Procedure time, procedure completion, patient discomfort, complication or critical flaw, global rating performance
Gomez et al[20], 2015	Basic skills training	3 modules, 3 wk in total		Expert evaluations (GAGES scale)	Physical simulator group, combination group	Composite score of competency, performance time, visualization of mucosa
Grover et al[8], 2015	Basic skills training	6 h of didactic lectures and 8 h of VR simulation-based training with expert feedback		Expert evaluations (JAG DOPS scale)	VR simulation training only (no experts feedback)	Composite score of competency
Hashimoto et al[9], 2018	Basic skills training	Not limited		Objective metrics	Ten repetitions of each VR simulator	Precedure skills
Koch et al[11], 2015	Basic skills training	50 (group I) or 100 (group II) VR colonoscopies		Expert evaluations	50 (group I) or 100 (group II) VR colonoscopies	Procedure time, procedure completion
McIntosh et al[21], 2014	Basic skills training	16 h of VR simulator training		Expert evaluations, objective metrics	No intervention	The number of proctors 'assists' required per colonoscopy. Precedure time, precedure skills, patient discomfort
Park et al[22], 2007	Basic skills training			Expert evaluations (global rating scale)	No intervention	Procedure completion, complication or critical flaw
Piskorz et al[16], 2020	Basic skills training	8-h worked utilizing two GI Mentor™ in a specialized clinical simulation center		Objective metrics		Precedure time, precedure skills
Shirai et al[23], 2008	Basic skills training	5 h simulation training + bedside training vs bedside training		Expert evaluations	Conventional, patient-based training only	Precedure time
Silva Mendes et al[24], 2021	Basic skills training	Theoretical and a hands-on module (20 h) in the GI Mentor II		Objective metrics		Cognitive score, precudure time, precedure skills, patient discomfort
Telem et al[18], 2014	Basic skills training	2 h a wk, 6 wk		Expert evaluations (GAGES scale), objective metrics	No intervention	Precudure skills, precudure time
Van Sickle et al[17], 2011	Basic skills training, advanced skills		Self-rating score	Expert evaluations (GAGES scale), objective metrics		Precedure time, precedure skills, patient discomfort

GAGES: Global assessment of gastrointestinal endoscopic skills; JAG DOPS: Advisory group direct observation of procedural skills; VR: Virtual reality; GI: Gastrointestinal.