Flexible Diagnostic & Therapeutic Endoscopy–P233

INITIAL EXPERIENCE USING AN ENDOSCOPIC SIMULATOR TO TRAIN
RESIDENTS IN FLEXIBLE ENDOSCOPY IN A COMMUNITY MEDICAL
CENTER BASED RESIDENCY PROGRAM. Robert D. Fanelli, MD, FACS;
Mark T. Mainella, DO; Justin R. Clark, DO; Keith S. Gersin, MD, FACS, Surgical Specialists of Western New England, PC, Pittsfield, MA; Berkshire Medical Center, Department of Surgery, Pittsfield, MA; University of Cincinatti, Department of Surgery, Cincinatti, OH.

Introduction: The importance of training surgical residents in GI endoscopy has been recognized for years. Despite mandates from the RRC, few programs have managed to incorporate effective endoscopic training into their curricula, making it difficult for their graduates to be credentialled in GI endoscopy. We report our initial success using a
virtual reality endoscopic simulator to improve education in flexible endoscopy.
Methods: Prior to October 2001, residents were taught flexible endoscopy by staff surgical endoscopists. Because flexible endoscopy requires different skills than surgery, even senior residents spent considerable time observing endoscopic procedures rather than performing them. Although residents met RRC minimums, rarely did they log enough actual experience to qualify for clinical privileges. Since October 2001, we have used an endoscopic simulator to train residents in GI endoscopy. Residents are given monthly assignments of simulated cases. Junior residents master diagnostic procedures, and therapeutic procedures are emphasized in senior years. PGY-2 and PGY-4 residents participate in a 3-month surgical endoscopy rotation, where they gain significant clinical experience.
Results: The simulator allows residents to master the learning curve quickly, so that they may perform the majority of procedures independently when they rotate through the surgical endoscopy service.
Residents learn endoscopy quickly since they develop basic skills using the simulator, and build advanced skills during clinical exposure. Chief residents planning careers in general surgery have successfully logged enough cases to perform GI endoscopy with facility and qualify for privileges.
Conclusions: Endoscopic simulators provide surgical residents with valuable training that allows them to master basic skills quickly, and prepares them to perform GI endoscopy in less time than exposure based learning.

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