Virtual reality simulation training for health professions trainees in gastrointestinal endoscopy

The effectiveness of esophagogastroduodenoscopy (EGD) for diagnosis and management of upper gastrointestinal disorders is dependent on operator skill. Endoscopic training focuses on not only the technical skills needed for endoscope manipulation, but also cognitive skills, such as lesion identification, and non-technical skills, such as communication and teamwork [1]. Novice endoscopists encounter a prolonged learning curve, as they need to master all three skill domains to provide safe, high-quality endoscopic care [2, 3]. Despite EGD being a commonly performed procedure even taught to primary care physicians [4], there is no standardized technique or curriculum. Learning curve data suggest that novices acquire competency in EGD after 200 to 250 procedures [2, 5]. Initial technical challenges include advancement of the endoscope through the oral cavity and hypopharynx and intubation of the upper esophagus [6]. This may be further compounded by suboptimal hand positioning, as novices may not know how to move their hands and arms in a manner that is both safe for the patient and minimizes their own risk of musculoskeletal strain injury. Conversely, experienced endoscopists can use techniques such as changing their left-hand position to rotate the tip of the endoscope without twisting their right hand. Such skills are best learned through focused instruction and deliberate practice [7]. In this issue of Endoscopy International Open, Sugimoto and Osawa [8] report on a novel method to teach operator positioning to novice endoscopists. They delivered a simulation-based curriculum to 122 medical students at the Hamamatsu University School of Medicine that centered around the four-position method. In this method, the left hand is: a) held at the shoulder when inserting the endoscope; b) beside the hip when obser

Background and Aims Non‐technical skills (NTS), involving cognitive, social and interpersonal skills that complement technical skills, are important for the completion of safe and efficient procedures. We investigated the impact of a simulation‐based curriculum with dedicated NTS training on novice endoscopists’ performance of clinical colonoscopies. Methods A single‐blinded randomized controlled trial was conducted at a single center. Novice endoscopists were randomized to a control curriculum or a NTS curriculum. The control curriculum involved a didactic session, virtual reality (VR) simulator colonoscopy training, and integrated scenario practice using a VR simulator, a standardized patient, and endoscopy nurse. Feedback and training were provided by experienced endoscopists. The NTS curriculum group received similar training that included a small‐group session on NTS, feedback _targeting NTS, and access to a self‐reflective NTS checklist. The primary outcome was performance during two clinical colonoscopies, assessed using the Joint Advisory Group Direct Observation of Procedural Skills (JAG DOPS) tool. Results Thirty‐nine participants completed the study. The NTS group (n = 21) had superior clinical performance during their first (P < 0.001) and second clinical colonoscopies (P < .0.001), compared to the control group (n = 18). The NTS group performed significantly better on the VR simulator (P < 0.05) and in the integrated scenario (P < 0.05). Conclusion Our findings demonstrate that dedicated NTS training led to improved performance of clinical colonoscopies among novices.

Background/objectives: Virtual Reality (VR) is a developing technology, which seems to have extensive applications in different areas such as entertainment, sports, gaming and simulation. In the current scenario, due to Computer-generated imagery and content aim at simulating a real presence through senses capability, it has functional applications in the medical field. So, there are requirements to study its applicability in the medical field. Methods: Relevant papers on VR in the context of the medical field are identified and studied. This paper is a literature review based analysis, where we are trying to find how this technology is going to solve a medicalrelated problem in saving the life of the patient and what are the significant applications. Results: VR provides a simulated environment to interact with the 3D world. Medical professionals are developing and implementing this technology for training, diagnosis and virtual treatment during a critical situation. The study sees that there is good potential for VR in the medical field. We also studied the processes involved in implementing this technology in the medical field. Finally, this paper identifies fourteen major applications of VR in the medical field with description. This technology is helping to create quality healthcare services during complicated cases. Conclusions: VR is used effectively for better surgical technique. It creates detailed virtual models of a patient's anatomy. It helps physicians to effectively move around and view virtual 3D images from different angles. This technology is currently applied in cardiology and Neurology for monitoring and improves patient outcomes. It plays a significant role to help physician related to trauma and other fractures. VR is an emerging technology which can also be used in hospitals and clinics for rehabilitation & training approaches. The applications of this technology are in virtual guides and to fulfil different other virtual goals in the medical field. It seems like an efficient technology to teach body fitness and help create a positive impact on doctors and the patient. This technology leads to creative and exciting discoveries in the medical field.