Endoscopy Practice and Safety
Peter B. Cotton
11. Training and credentialing in gastrointestinal endoscopy
Fig. 1Variable recommendations of minimal training requirements.
Fig. 2Minimum number of procedures before competency can be assessed.
Fig. 3Compact-EASIE porcine model hemostasis simulator.
Fig 4Close-up view of porcine stomach with arteries sutured in attached to catheters for hook-up to tubing connecting vessels to
pump. The trainee puts together band ligation device for varices treatment simulation.
Fig, 5Endoscopic image of spurting arterial bleeding realistic simulation using the EASIE model.
Fig. 6Results of three intensive EASIE simulator workshops in hemostasis over 7 months on a 10-point analogue scale to rate skill
Fig. 7Variable learning curves of different techniques on the EASIE simulator.
Fig. 8Objective data on colonoscopy technical success learning curve.
Fig. 9Reported accuracy of EUS compared to histopathology for the local staging of esophageal carcinoma, gastric cancer, pancreatic
cancer, carcinoma of the papilla of Vater, and rectal cancer.
Fig. 10Minimum number of EUS procedures before competency can be assessed.
Fig. 11Comparison of available methods of endoscopic instruction.
Fig. 12Artificial tissue colonoscopy 'Phantom' simulator, University of Tübingen.
Fig. 13Combine artificial tissue 'Phantom' upper GI simulator with integrated chicken heart tissue papilla for ERCP simulation.
Fig. 14Labor-intensive, hands-on, simulator hemostasis training using EASIE model with 1:1 faculty to fellow ratio.
Fig. 15Immersion AccuTouch® colonoscopy simulator.
Fig. 16Mentor Simbionix colonoscopy virtual reality simulator.
Fig. 17Multiple simulated cases allow an individualized training program to be set of trainee and multiple pathologies, anatomical
variations, and varying degrees of difficulty.
Fig. 18Special handeye coordination exercises can be incorporated along with simulated procedures. In this game, the trainee must puncture all
bubbles which appear with the needle without touching the wall.
Fig. 19Therapeutic applications built in to the GI Mentor colonoscopy module. Tactile feel within the accessory is still under development.
Fig. 20ERCP module on GI Mentor.
Fig. 21Training modalities to complement standard supervised endoscopy.
Copyright © Blackwell Publishing, 2004