Moorthy, K.; Munz, Y.; Jiwanji, M.; Bonn, S.; Darzi, A.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA114
Academic Journal
Background: This study aims to establish the validity and reliability of an upper Gl simulator as a tool for the assessment of endoscopic skills. Methods: Subjects with varying levels of experience undertook 4 cases on the upper Gl simulator. Data on the time taken for the procedure percentage of mucosa and pathologies visualised and the number of inappropriate retroflexions were retrieved from the simulator's database. We calculated the efficiency of performance as the percentage of mucosa visualised divided by the total time taken for the procedure. We analysed the data for all 4 cases to calculate the reliability of the simulator's assessment. Statistical analysis was done using non-parametric tests and Cronbach's alpha co-efficient for reliability. Results: There were 11 novices (group 1), 11 trainees with intermediate experience (10-50 procedures, group 2) and 10 experienced endoscopists (> 200 procedures, group 3). There was a significant difference in the total time taken to perform the procedure (p < 0.001), percentage of mucosa visualised (p < 0.001), efficiency of performance (p < 0.001) percentage of pathologies visualised (p = 0.002) and the number of inappropriate retroflexions (p = 0.016 across the groups. Inter,group analyses were significant between groups 1 and 3 for all parameters and in between 2 and 3 for four of the parameters. There was a significant difference in the percentage of mucosa visualised between groups 1 and 2. The reliability of performance assessment was 0.90 for time taken, 0.89 for mucosa visualised, 0.86 for efficiency and 0.80 for pathologies visualised. Conclusion: This study has established the construct validity and the reliability of the simulator which can strongly discriminate between groups with varying experience.


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