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

Colorectal Dis. 2015 Jul;17(7):627-34. doi: 10.1111/codi.12887.

Abstract

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.

Keywords: Colonoscopy; cadaver model; colonic strictures; simulated colonoscopy; stents.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Cadaver
  • Clinical Competence
  • Colonic Diseases / surgery*
  • 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*
  • Simulation Training / methods*