Exploring Use of Endoscopy Simulation In North American Pediatric Gastroenterology Fellowship Training Programs.

Abstract

OBJECTIVES Increasing evidence supports simulation-based training; however, limited data exists regarding its use in pediatric gastroenterology (GI). We explored the use of simulation-based endoscopy training in pediatric GI fellowship programs across North America. METHODS GI fellowship program directors (PDs) from the United States (US) and Canada were surveyed between Aug-Nov 2018. The pre-tested, electronic survey comprised 3 sections: program demographics; details of current simulation-based training; and PDs' perceptions of endoscopy simulation. Responses were analyzed using descriptive statistics. RESULTS Forty-three of 71 (61%) PDs responded (6 Canadian, 37 US). Programs were predominantly academic (95%) and enrolled 1.87 ± 1.01 fellows/year. Twenty-four programs (56%) reported using simulation for endoscopy training, while 8 (19%) used simulation for non-procedural education. Only 2 programs (5%) used endoscopy simulation for assessment. Of those using simulation (n = 24), upper endoscopy and colonoscopy were trained most frequently, and mechanical simulators were used most commonly. Eight programs (33%) required simulation training prior to clinical performance. While 10 programs (42%) provided protected training time, only 2 (8%) tracked hours. Three programs (12.5%) reported having an organized curriculum and 6 (25%) train their endoscopic trainers. Cost, time constraints and lack of a standardized curriculum were perceived as key barriers to integration. Most PDs reported a need for endoscopy simulation to train both technical and non-technical skills; however, they felt simulation cannot replace clinical experience. CONCLUSION PDs recognize the potential importance of endoscopy simulation, particularly for novices; however, only 56% report using it. Perceived barriers indicate the need for inexpensive portable simulators and a validated pediatric simulation curriculum to promote uptake.